Spinal Fusion

Stem cell therapy for Spinal Fusion

Spinal fusion is surgery to join together two bones (vertebrae) in the spine. Fusion permanently joins two bones together so there is no longer movement between them. Fusing of the spine is used primarily to eliminate the pain caused by abnormal motion of the vertebrae by immobilizing the faulty vertebrae themselves. Spinal fusion is done most commonly in the lumbar region of the spine, but it is also used to treat cervical and thoracic problems. The indications for lumbar spinal fusion are controversial. People rarely have problems with the thoracic spine because there is little normal motion in the thoracic spine.

Spinal fusion may relieve symptoms of many back conditions, including:

Degenerative disk disease
Spinal stenosis

There are different methods of spinal fusion.

Bone is taken from the pelvic bone or other source. The bone is used to make a bridge between vertebrae that are next to each other. This bone graft helps new bone grow.
Metal implants (cages, pedicle screws often made from titanium) during TLIF, PLIF, ALIF are used to hold the vertebrae together until new bone grows between them.

Treatment of Spinal Fusion using of Bone Marrow Derived Stem Cells:-

The primary bone-forming cell in the body is the osteoblast and its precursor is the MSC. Bone formation occurs as the extracellular matrix, which is produced by the osteoblast, becomes mineralized. Osteoprogenitors refer to all the cell stages stemming from Mesenchymal stem cells up to the osteoblast. This naturally occurring differentiation process is regulated by a series of naturally occurring proteins, or growth factors, that eventually guide the MSC to form osteoblasts.

Protocol Outline for Spinal Fusion Treatment:-

We transplant bone marrow stem cells concentrate by mixing with Synthetic/Autologous graft with/without cultured Mesenchymal stem cells (based on the patient/trauma condition) between two vertebrae to get higher spinal fusion rate.

“Bone marrow-derived stem cells concentrate (BMSCs)” provide a rich growth factor environment that may enhance the bone healing response in spinal fusion cases. Complete bone formation is dependent on the all the cell types contained in Bone marrow stem cells concentrate. The iliac crest contains bone marrow which is a rich source of the regenerative cells needed for bone formation, including:-

Mesenchymal Stem Cells (MSCs):- MSCs which differentiate into many types of cells such as bone, cartilage, neuron and so more.

Hematopoietic Stem Cells (HSCs):- HSCs which differentiate into all types of blood cells and also provide enhance environment for MSCs activation.

Endothelial Stem Cells (ESCs):- ESCs which differentiate into all types of blood vessels also release BMP-2 and BMP-6 which is very important growth factor for bone formation.

Platelets: –

1) To modulate the regeneration process
2) Recruit bone marrow progenitor cells to loci of injury
3) Provides adhesion site for stem cells
4) Platelets fibrin provides migration highway at the site of injury

Autologous adult stem cells concentrated from bone marrow harvested from the iliac crest may become a viable alternative to iliac crest bone grafting and its inherent associated morbidity. Spinal Fusion rate is higher by using of bone marrow stem cells concentrate than iliac crest bone graft (ICBG). Previous reports (Connolly, Gangji, Hernigou et al) have shown that high concentrations of adult stem cells from iliac crest bone marrow can enhance the rate and amount of bone formation.
Sometimes we refer to transplant cultured mesenchymal stem cells (MSCs) isolated from bone marrow, cord tissue after evaluation of complete case study because MSCs has the property to differentiate into many types of cells such as bone, cartilage and neuron and so more and also have better regeneration capacity.
We also start stem cell supplement (Stem-Kine) during and after stem cell transplantation to get better improvement overall.

Follow-up with patients:-

Our medical staff members will be in contact with patients to get complete follow-up at 1, 3, 6 month intervals to monitor all the evaluation.

Scientific Articles:-

Johanson et al. 2008 , Neurosurgical associates, Texas, USA. Concentrated Autologous Adult Stem Cells vs. Autologous Iliac Crest Bone for Instrumented Fusion of the Lumbar Spine: Clinical and Laboratory Results for Two Consecutive Patients
Shen et al. 2005, The Spine Journal. Cell Technology for Spinal Fusion. s 3.Robert et al. 2005, The Journal of Bone and Joint Surgery, Aspiration of Osteoprogenitor cells for augmenting Spinal Fusion: Comparison of Progenitor cell concentrations from the Vertebral Body and Iliac

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