Treating spinal disorders with stem cells is becoming increasingly feasible. Recent advances in science have allowed researchers and spinal surgeons to study the ability of stem cells to repair worn intervertebral discs, spinal cord injuries and to activate bone growth in spondylosis.
What stem cells are used for in spinal cord injury?
In recent years, stem cells have been the focus of regenerative medicine, including treatments for spinal cord injuries. Regional stem cells taken directly from bone marrow, adipose tissue, or blood are capable of both mitosis and multipotent differentiation into various cell types. Stem cells are used to replace or repair damaged tissues, including those in the spinal cord, by differentiating into cells that accelerate the healing process or directly reconstruct tissues.
Despite many years of research into the nature of stem cells and the process of differentiation, their engraftment, along with biochemical and physiological monitoring of the patient’s condition during transplantation, is still a difficult task. Advances in natural sciences have enabled the modeling of the spatial organization of cells, which simultaneously allow the retention of cells in the transplantation area and the penetration of nutrients to maintain cell viability. Advances in genetic engineering allow stem cells to be modified to induce selective growth factor expression and accelerate tissue repair, including spinal cord tissue.
Stem cells and spinal surgery
Stem cell transplantation can be used to alleviate the possible severe effects of spinal cord injuries by restoring neurons. Tissue engineering is working on developing new techniques for spinal surgery needs, mainly to fuse bones and achieve spinal stabilization in spondylosis. Also, many researchers are working to ensure that iatrogenic damage to peripheral nerves and skeletal muscles surrounding the spine, which can occur during surgery when spinal access is being prepared, will be less dramatic in the long term for the patient’s motor ability. Overall, although stem cell therapy is still in the research phase, it offers promising opportunities in the treatment of spinal disorders as well as risk reduction in spinal surgery.
Spondylodesis: Indications and spinal cord considerations
Spondylodesis is surgery to fuse two or more vertebrae together to correct pain and deformities caused by degenerative diseases, tumors, fractures, or spinal misalignment. This helps to eliminate pain and improve spinal stability, including in cases where the spinal cord is affected.
Autologous bone marrow transplantation from the iliac bone is traditionally used, but it can cause complications. Allogeneic transplants (from a donor) or synthetic materials do not create the cells needed for fusion.
Mesenchymal stem cells (MSCs) derived from bone marrow, adipose tissue, or other sources can differentiate into osteoblasts and promote bone fusion, which is essential for spinal stability and can help in cases involving the spinal cord. Adipose-derived stem cells (ADSCs) have also shown efficacy in these processes.
Studies show that using stem cells from adipose tissue and treating them with growth factors can be effective in spondylosis, including when the spinal cord is involved.
Degenerative spine disease and intervertebral discs
Degenerative spine disease is associated with molecular changes in the intervertebral discs. A healthy disc consists of a pulposus nucleus, rich in proteoglycans and type II collagen, and a fibrous ring composed of type I collagen fibers. These structures provide cushioning and resistance to strain.
With age or due to other factors, calcification of the closure plate occurs, which decreases the nutrient supply to the disc, causing it to degenerate. This can lead to pain and pinched nerves.
Conservative treatment includes physical therapy, pain medications, acupuncture and injections. Surgery, such as intervertebral disc replacement or spondylosis, may be necessary if symptoms and deformities progress.
Mesenchymal stem cells (MSCs) show potential for pulposus nucleus repair. Studies have shown that MSCs can differentiate into pulposus nucleus cell-like cells through environmental stimulation or genetic manipulation. MSCs transplanted into degenerated discs can improve their condition by increasing disc thickness and improving disc hydration.
Spinal cord injuries (SCI)
Spinal cord injuries are injuries to the spinal cord, often resulting in serious consequences, including death. The main causes are motor vehicle accidents, sports, household and workplace injuries. Males 16-30 years of age are most often affected. Spinal cord injury involves several stages, each characterized by different biochemical processes.
- Acute stage – mechanical damage to nerves and tissues, tumor and blood flow blockage, hypoxia.
- Subacute stage – inflammation, oxidative stress, activation of immune responses and neuronal death.
- Chronic stage – scar tissue forms that interferes with nerve repair.
Studies show that stem cell transplantation can accelerate recovery from SCI, including remyelination of nerves and axons. This is possible at different stages of the disease and helps to reduce inflammation and maintain a favorable microenvironment for recovery.
Embryonic stem cells have great potential for treatment as they can indefinitely divide and differentiate into different cell types. However, their use raises ethical issues as these cells are often derived from aborted material. Clinical trials have taken place in the US, but embryonic cells are not often used due to ethical and legal issues.
Mesenchymal stem cells (MSCs) – are widely used in research because they are easy to obtain and use. These cells help stimulate nerve regeneration and inhibit inflammation. Animal studies have shown that MSCs promote axon regeneration and reduce demyelination. However, MSCs cannot directly repair damaged tissue, and their role is to create a favorable environment for repair.
Neural stem cells (NSCs) have the ability to differentiate into neurons, oligodendrocytes, and astrocytes, making them a promising treatment. Studies show that NSCs can restore function in animals and promote the regeneration of nerve fibers and axons. However, transplantation of NSCs at late stages of the disease is less effective.
Conclusion
The use of stem cells in the treatment of spinal disorders and spinal cord injuries represents a promising direction in regenerative medicine. Mesenchymal stem cells (MSCs) and neural stem cells (NSCs) show promising results in repairing damaged tissues such as intervertebral discs and nerve fibers. They are able to not only maintain and repair tissues, but also create a favorable microenvironment for regeneration.
Despite significant advances, there are a number of limitations, including difficulties with cell engraftment and ethical concerns regarding the use of embryonic stem cells. However, advances in the use of stem cells, as well as improvements in genetic engineering technologies, are opening new horizons in the treatment of degenerative spinal cord diseases as well as in rehabilitation after spinal cord injury.
