What is Degenerative Disc Disease?
Degenerative disc disease is not really a disease at all, but rather a degenerative condition that at times can produce pain from a damaged disc. Disc degeneration is actually a natural part of aging, it is the process where the disc between the bones of the spine becomes thinner by losing its hydration. Over time all people will exhibit changes in their discs consistent with a greater or lesser degree of degeneration. However, not all people will develop symptoms. In fact, degenerative disc disease is quite variable in its nature and severity.
Osteoarthritis in the spine, e.g. joint changes in the facet joints of the spine can occur as a result of disc degeneration. (Peter F. Ullrich, 2017)
The image below compares a healthy disc as opposed to DDD.
What is a Disc Bulge or Herniated Disc?
A Disc Bulge or a Herniated Disc can potentially start with an annular tear, this refers to the outer layer of a spinal disc being torn. As this tear occurs, it will cause the fluid to leak out. The disc at this stage will lose its hydration. (Spine Health, 2017)
What is the difference between a herniated disc and a bulging disc?
Bulging discs are still contained within the annulus; the leaking fluid will create a small bulge where by the bulge can press on the surrounding nerve.
A herniated disc is a traumatic focused injury to the disc, which results in a portion of the nucleus, or inside material, pushing out into a nerve. (Spine Health, 2017)
image ref: Ehealthstar.com. Available at: http://www.ehealthstar.com/conditions/bulging-herniated-disc/broad-based-herniation [Accessed 25 Jul. 2017].
How Do Stem Cells Work to Treat Spine Issues?
In the past, when we have treated patients with osteoarthritis, as well as either disc bulges, disc herniations or neuropathic pain, their symptoms are the initial target which show improvements. This specifically relates to the level of pain the patient is suffering from.
There is evidence of safety and feasibility in the treatment of Degenerative Disc Disease with Stem Cells that indicates a favorable outcome for discogenic pain reduction. The use of adult stem cells is an innovation that promises fewer complications and improved function in patients who are demographically suitable for stem cell therapy. (Hansraj KK., 2015)
The SVF cells have the potential to;
- Target and fight off inflammation
- Repair damaged nerve cells
- Differentiate to the matching tissue type
(in this scenario: jelly like disc material & nerve cells)
- Soften scar tissue formation
- Re-hydrate bulging discs
(Schroeder, 2015) (Condé-Green et al., 2016) (Wu et al., 2013) (Gibbs et al., 2015) (Jo et al., 2014) (Michalek, 2015) (Sacerdote et al., 2013) (Vickers et al., 2014)
Treating Degenerative Discs
Once these cells have home to the inflamed degenerated disc, they are able to resolve the inflammation directly at the site, this will resolve your pain. Additionally they have shown the ability to differentiate into the jelly like disc material which provides the ability to repair the damaged disc. This material is called the Nucleus Pulposus Matrix.
Stem Cells can differentiate into bone, cartilage, skeletal muscle and ligamentous tissue. The exact phenotype of nucleus pulposus cells has yet to be determined, Nonetheless, researchers have demonstrated the environment they are injected into can play a key role in Stem Cell differentiation into a nucleus pulposus-like cell. Many researchers such as Richardson et al & Risbud et al have found certain conditions prompted MSC differentiation towards nucleus pulposus-like cells. (Schroeder, 2015)
Treating Disc Bulges
The cells will home to inflammation surrounding the site of the bulge; these cells will resolve the inflammation surrounding the bulging disc. This will allow your neuropathic pain to decrease. (Vickers et al., 2014)
The second stage of the cellular repair will apply to a disc which is currently de-hydrated. These cells are able to re-hydrate the disc; this will cause the bulge to decrease in size. Almost like flat tire in a vehicle, as the tire is inflated the bulge which appears on the side walls of the tire will decrease.
The decrease of this bulge is able to relieve the physical pressure which has been applied to the nerve causing the inflammation which leads to neuropathic pain. (Sacerdote et al., 2013)
Treating Disc Herniations
As stated these, cells will home to and resolve the inflammation surrounding the herniated disc. This will allow your neuropathic pain to decrease.
The disc is able to be re-hydrated; the herniation may decrease in size. The decrease of the herniation will relieve the physical pressure which has been applied to the nerve causing the inflammation which leads to neuropathic pain.
Nishimura and Mochida were the first to re-implant these cells in a disk herniation rat model and reported decreased degeneration of the annulus fibrosus.
(Vickers et al., 2014) (Schroeder, 2015)
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