Advances in biological techniques for treatment of lumbar discogenic pain

Jeffrey D. Petersohn MD
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引用次数: 1

Abstract

Treatment of lumbar discogenic pain is based upon restoration of mechanical function and suppression of nociception within the intervertebral disc. The biophysical and pathologic basis of disc injury is reviewed with discussion of treatment modalities. Ablative intradiscal ethanol and restorative intradiscal fibrin appear promising. Intradiscal platelet-rich plasma is tantalizing, but unproven. Biochemical modification of anabolic-catabolic balance by intradiscal administration of growth factors including BMP-7 and GDF-5 in clinical trials, as well as multiple investigational pharmacologic moieties, is discussed. Successful use of intradiscal autologous and mesenchymal stem cells has been demonstrated for in animal models, but human experience is limited. Clinical considerations and risks of these treatments are discussed.
生物技术治疗腰椎间盘源性疼痛的进展
腰椎间盘源性疼痛的治疗是基于恢复机械功能和抑制椎间盘内的伤害感觉。本文综述了椎间盘损伤的生物物理和病理基础,并讨论了治疗方法。消融性椎间盘内乙醇和修复性椎间盘内纤维蛋白似乎很有前景。椎间盘内富血小板血浆是诱人的,但未经证实。本文讨论了在临床试验中通过肝内注射生长因子(包括BMP-7和GDF-5)以及多种研究性药理学成分对合成代谢-分解代谢平衡的生化修饰。椎间盘内自体干细胞和间充质干细胞的成功应用已在动物模型中得到证实,但人类经验有限。讨论了这些治疗的临床注意事项和风险。
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