This exciting new study says that you may soon be cured of that awful ache in your back.

According to the study from Penn Medicine, scientists believe we will soon be able to grow new spinal discs from a patient's own cells as a means of replacing the deteriorated ones that cause back and neck pain.

For the first time ever, spinal discs that were grown from stem cells were successfully implanted and provided long-term function in the largest animal model ever evaluated for bioengineered disc replacement.

The soft tissues in the spinal column, the intervertebral discs, are essential for the motions of daily life, such as turning your head to tying your shoes. At any given time, however, about half the adult population in the United States is suffering from back or neck pain, for which treatment and care place a significant economic burden on society—an estimated $195 billion a year.

While spinal disc degeneration is often associated with that pain, the underlying causes of disc degeneration remain less understood. Today's approaches, which include spinal fusion surgery and mechanical replacement devices, provide symptomatic relief, but they do not restore native disc structure, function, and range of motion, and they often have limited long-term efficacy. Thus, there is a need for new therapies.

Tissue engineering holds great promise. It involves combining the patients' or animals' own stems cells with biomaterial scaffolds in the lab to generate a composite structure that is then implanted into the spine to act as a replacement disc. For the last 15 years, the Penn research team has been developing a tissue engineered replacement disc, moving from in-vitro basic science endeavors to small animal models to larger animal models with an eye towards human trials – "optimistically" in the near future.

"This is a major step: to grow such a large disc in the lab, to get it into the disc space, and then to have it to start integrating with the surrounding native tissue. That's very promising," said Robert L. Mauck, co-senior author of the paper, which was published in Science Translational Medicine. "The current standard of care does not actually restore the disc, so our hope with this engineered device is to replace it in a biological, functional way and regain full range of motion."

Researchers demonstrated successful total disc replacement in the goat cervical spine. They chose the goat because its cervical spinal disc dimensions are similar to humans' and goats have the benefit of semi-upright stature. Eight weeks after the implant, MRI results suggest that disc composition was maintained or improved, and that the mechanical properties either matched or exceeded those of the native goat cervical disc.

"When you look at the success in the literature from mechanical devices, I think there is a very good reason to be optimistic that we could reach that same success, if not exceed it with the engineered discs [in humans]," said Harvey E. Smith, MD, co-senior author and clinical lead on the study.

The research team credits the success of the work to the multidisciplinary and translational approach they've taken since it began at Penn Medicine, which is home to the many experts from the different departments and schools who were involved in this project.

The next step will be to conduct longer-term studies to further characterize the function of the engineered discs in the goat model, the authors said, as well as model the degeneration of spinal discs in humans and to test how their engineered discs perform in that context.

"There is a lot of desirability to implant a biological device that is made of your own cells," Smith said. "Using a true tissue-engineered motion preserving replacement device in arthroplasty of this nature is not something we have yet done in orthopaedics. I think it would be a paradigm shift for how we really treat these spinal diseases and how we approach motion sparing reconstruction of joints."

(Source: Penn Medicine News)

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