Cell Therapy for Intervertebral Disc Regeneration: Progress and Hurdles in Clinical Translation

Abstract

Low back pain (LBP) is a pervasive global issue causing substantial disability and significant economic burden. The primary etiological factor behind LBP is intervertebral disc (IVD) degeneration, initiated in early adolescence and potentially leading to multiple spinal pathologies. However, current treatments for discogenic LBP are mainly palliative or involve invasive surgery, lacking disease-modifying therapies. Regenerative strategies, including cell therapy, may offer promising avenues to address the underlying pathology of IVD degeneration. Preclinical studies and clinical trials have demonstrated the potential of intradiscal cell transplantation to alleviate disc degeneration and associated pain with an overall favorable safety profile. Nonetheless, clinical trials present challenges, such as varying patient inclusion criteria, lack of adequate control groups, and short follow-up periods, necessitating cautious interpretation of results. This narrative review aims to provide an overview of clinical trials published to date and discuss the progress and translational hurdles of cell-based therapies for IVD degeneration and discogenic pain.