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"Degeneration"

Review Article

Biological Treatments for Degenerative Disc Disease
Young-Joon Kwon, Hyunchul Shin
J Adv Spine Surg 2013;3(2):84-91.   Published online December 31, 2013
Chronic low back pain is a common cause of disability causing major socioeconomic consequences. Recent advances in disc biology and tissue engineering techniques enable a new emerging field of biologic treatments for degenerative disc disease. These new treatment modalities aim to achieve structural and functional restoration of the degenerated discs by introducing protein, cells, genetic modifications of resident disc cells or exogenous cultured cells, and use of biomaterials. So far, these techniques have been successfully applied to treat degenerated discs in preclinical setting, including in vitro or in animal studies. Application of these treatment modalities for degenerative disc disease should be individualized according to the degree of disc degeneration. For the successful application in clinical field, the biologic treatment should achieve the functional restoration of the disc, resulting in pain regulation.
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Original Article
Biologic Treatment for Disc Degenerative Disease
Jae Hyup Lee, Hyeong-Seok Lee, Ji-Ho Lee
J Adv Spine Surg 2011;1(1):15-22.   Published online June 30, 2011
Introduction
Degenerative change of the vertebral disc is known to be caused by inherited factors, aging and mechanical and environmental factors and it progresses due to the decreasing amount of proteoglycan in the vertebral disc. Resolving the imbalance between the synthesis and break down of proteoglycan is an important strategy for slowing additional degeneration and increasing regeneration of the disc. Body: To regenerate vertebral discs, many attempt have been made to get curative value such as direct injection of growth factors like BMP-2, BMP-7, IGF-1, TGF-β1, GDF-5 and FGF into the disc or transplantation of cytokine for improving the composition of proteoglycan. But these proteins have a short acting time and so repeated transplantation is necessary even if transplantation into the disc is done. So, much research has been done on genetic transplantation, which may improve certain proteins. Other trials of transplantation of nucleus pulposus cells, combinations of stem cells with scaffold and amalgamation with genetic care have also been done. But the safety of these therapies has not yet been completely established.
Conclusion
Biological therapy for degenerative disc disease has many benefits compared with the conventional therapies. Hereafter, according to additional research, the clinical indications for biological therapies are expected to increase. Clinical applications should be performed after securing enough results for establishing the safety and effectiveness of these new procedures.
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