Perspectives of Cell-Based Therapy for Degenerative Diseases of the Spine: The Reason for Choosing the Epidural Space

Abstract

Intervertebral disc degeneration (IDD) is a chronic disease that causes significant disability and dependence and exerts a high cost on society. Concerning IDD, it is the most common cause of back pain, involving any segment of the spine. It is one of the most frequent reasons for consultation in the general population, second only to headache, affecting 80–85% of people throughout life. Current therapeutic strategies focused on IDD are primarily conservative, including physical therapy and antiinflammatory medication. Surgical techniques intend to stabilize the spine and/or decompress the spinal or foraminal canal, searching for relieve of symptoms, and, however, do not address the cause of the degeneration and even accelerate the degeneration of adjacent segments. Understanding of the biology of platelet-rich plasma (PRP) and other growth factors directed us to use of PRP as a promising biological therapeutic strategy for enhancing the regenerative process, searching for the healing of the intervertebral disc. With current few in vitro studies, and fewer clinical studies linking the bases of regenerative medicine (RM) in the management of degenerative disc disease, our pioneering research was to state the bases, fundamentals, results, and the new trends around the RM techniques focused on the pathology of the spinal canal, taking the advantages that offer the epidural route.