Update on Stem Cell Applications in Spine Surgery

The application of stem cells for spine fusion, degenerative disc disease, and spinal cord injury displays significant promise for improvement upon current techniques. Stem cells possess both the ability to divide indefinitely while remaining in an undifferentiated state and either pluripotency or multipotency to divide into a variety of cell types or lineages. Embryonic stem cells are harvested from the inner mass of the blastocyst, occurring approximately 4 to 5 days after fertilization and can differentiate into cells of any germ or somatic lineage. Although their pluripotency may make them a useful therapeutic candidate, the ethical controversy and regulations concerning embryonic stem cells limit their clinical use. However, the recent use of adult stem cell lines provides an alternative. Adult stem cells can be harvested from living donors and more commonly demonstrate multipotency, as they have begun differentiation toward somatic lineages. Adult stem cells are prevalent within bone marrow (BM) where 2 types are present: hematopoietic stem cells, which divide into various blood components, and mesenchymal stem cells (MSCs), which can produce bone, cartilage, and adipose tissue. Adipose stem cells are another popular source of adult stem cells. Their abundance in many patients, and their relative ease of har-vest, has led to their wide usage in clinical treatment. Spine fusion, Stem cells Learning Objectives : After participating in this CME activity, the neurosurgeon should be better able to: Describe the recent research investigating and evaluating the use of stem cells in spinal fusion, degenerative disc disease, and spinal cord injury.