Intradiscal application of hyaluronic acid in the non-human primate lumbar spine: radiological results

Pfeiffer, Michael; Boudriot, Ulrich; Pfeiffer, D.; Ishaque, Natascha; Goetz, Werner; Wilke, Axel

doi:10.1007/s00586-002-0478-7

Cited by 21 publications

(14 citation statements)

References 24 publications

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“…After 12 months, significant improvements in disability and pain were observed. This and other studies (170,216) indicate that different substances could be helpful in making curative treatment approaches more effective.…”

Section: Clinical Trialssupporting

confidence: 54%

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Regenerative treatment strategies in spinal surgery

Hegewald¹

2008

Front Biosci

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Intervertebral disc degeneration is considered a major source of low back pain. Recent advances in regenerative medicine have led to promising new approaches for the biological treatment of disc degeneration. Treatment modalities include the administration of growth factors, the application of autologous or allogenic cells, gene therapy, in situ therapy and the introduction of biomaterials or a combination thereof. Promising experimental results in vitro and in animal studies support the potential feasibility of these treatment modalities in clinical studies. We will review the current literature on regenerative treatment strategies and discuss potential drawbacks as well as opportunities in translating current knowledge into clinical practice. Major obstacles to regenerative treatment strategies might be insufficient nutritional supply, pain mediating factors and functionally impaired donor cells. Therefore, for clinical application, patient selection will be essential. Molecular, cellular and radiological diagnostic tools to evaluate the eligibility of patients for particular treatment strategies need to be developed. In spinal surgery, two approaches are conceivable. Patients operated on lumbar disc herniations often develop back pain due to disc degeneration months to years after surgery. Here, additional regenerative interventions would have a preventive intention, whereas interventions for painful degenerative disc disease as an alternative to spinal fusion or disc arthroplasty would be a curative approach.

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Section: Clinical Trialssupporting

confidence: 54%

“…Interestingly, hyaluronan by itself seems to be able to prevent degeneration processes. This was also confirmed in a study with Cercopithecus monkeys (170), which received intradiscal applications of high-molecular-weight hyaluronan after nucleotomy.…”

Section: Scaffoldssupporting

confidence: 52%

Regenerative treatment strategies in spinal surgery

Hegewald¹

2008

Front Biosci

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“…Similarly, acellular hyaluronan gels have been injected into IVDs of primate, pig and rat models after nucleotomy, demonstrating a decrease in the degeneration rate (Pfeiffer et al , ; Revell et al , ). Better results have been obtained through injections of hyaluronan gels associated with MSCs in a rat model (Crevensten et al , ).…”

Section: Intervertebral Disc Regeneration Strategiesmentioning

confidence: 99%

Intervertebral disc regeneration: from the degenerative cascade to molecular therapy and tissue engineering

Vadalà

Russo

Martino

et al. 2013

J Tissue Eng Regen Med

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Low back pain is one of the major health problems in industrialized countries, as a leading source of disability in the working population. Intervertebral disc degeneration has been identified as its main cause, being a progressive process mainly characterized by alteration of extracellular matrix composition and water content. Many factors are involved in the degenerative cascade, such as anabolism/catabolism imbalance, reduction of nutrition supply and progressive cell loss. Currently available treatments are symptomatic, and surgical procedures consisting of disc removal are often necessary. Recent advances in our understanding of intervertebral disc biology led to an increased interest in the development of novel biological treatments aimed at disc regeneration. Growth factors, gene therapy, stem cell transplantation and biomaterials-based tissue engineering might support intervertebral disc regeneration by overcoming the limitation of the self-renewal mechanism. The aim of this paper is to overview the literature discussing the current status of our knowledge from the degenerative cascade of the intervertebral disc to the latest molecular, cell-based therapies and tissue-engineering strategies for disc regeneration.

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“…Therapeutic strategies under investigation for the biological treatment of disc degeneration include the use of cellular components (mesenchymal stem cells, chondrocytes, culture expanded disc cells, disc allograft, etc. ), matrix-derivatives, and molecules influencing disc-cell metabolism and phenotype (Table 3) [ [17][18][19][20][21][22][23][24][25][26]. There are at least four different classes of molecules that are currently being investigated for disc therapy: anti-catabolics, mitogens, morphogens, and intracellular regulators.…”

Section: Molecular Therapy Strategies For Disc Diseasementioning

confidence: 99%

Molecular therapy of the intervertebral disc

Yoon

Patel

2006

Eur Spine J

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Disc degeneration is the loss of the normal nucleus pulposus disc matrix to a more fibrotic and less cartilaginous structure. This change in disc micro-anatomy can be associated with pain and deformity, however, prevention and treatment options of disc degeneration are currently limited. Much research is going on to understand intervertebral discs at a molecular/ cellular level in hopes of creating clinically applicable options for treating disc degeneration. This review article will give insight into the current and developing status of treating intervertebral disc degeneration from a molecular standpoint.

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Intradiscal application of hyaluronic acid in the non-human primate lumbar spine: radiological results

Cited by 21 publications

References 24 publications

Regenerative treatment strategies in spinal surgery

Regenerative treatment strategies in spinal surgery

Intervertebral disc regeneration: from the degenerative cascade to molecular therapy and tissue engineering

Molecular therapy of the intervertebral disc

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