Brian Subach, MD, a spine surgeon at the Virginia Spine Institute (VSI) and director of research for both VSI and the non-profit Spinal Research Foundation, discusses three areas of important research for spine surgery in 2011.
1. Stem cells. Spine surgeons and basic science researchers alike are exploring the different ways to use stem cells in the treatment of spinal disorders. Some spine surgeons are using stem cells to try to improve fusion procedures and promote disc regeneration. The stem cells used in these procedures aren't embryonic stem cells, but adult allograft stem cells that can be harvested from the patient's own body or donated from another person. "There is a huge misconception about stem cells because patients assume that we are using fetal cells," says Dr. Subach. "Some people, understandably, have moral objections to the use of such cells. In most cases, we are able to utilize the patient's own stem cells circulating in the bloodstream or from their own bone marrow. We have even begun to use allograft stem cells from adult tissue donors. The preliminary results are very exciting."
2. Platelet-rich plasma. Several areas in orthopedics are exploring the use of platelet-rich plasma (PRP) injections to promote healing of tendinopathies and promote joint regeneration. So far, such injections have been proven effective for patients with tennis elbow and plantar fasciitis, but little has work has been done in the spine. To create the injection, the patient's blood is drawn and spun in a centrifuge, removing the blood cells and leaving behind only the platelets and the serum. Dr. Subach's team has explored the use of PRP in the treatment of degenerating lumbar discs using various carriers. "Our research shows that injecting PRP into a disc space can be helpful, but it clears quickly from the disc space," says Dr. Subach. "We are researching ways to inject it into the disc with carriers that allow for a sustained release, allowing for maximum benefit from the PRP. In cases of degeneration, we hope to see a significantly increased benefit with prolonged exposure to PRP."
3. Genetic research. Spine researchers are now looking for a genetic basis for spinal diseases and disorders. For this research, families who have degeneration of the spine are examined to see if there are genetic indicators for the degeneration. If a genetic pattern for spinal degeneration is found, patients with that pattern can be identified and begin treatment presumably before the degeneration occurs. "We've already figured out how to fix the spinal problems that occur," says Dr. Subach. "Now, our focus at The Spinal Research Foundation is looking at ways to identify the genetic basis of spinal disease to find the patients at risk before they become symptomatic. We are screening large numbers of patients with familial disease. This should hopefully allow for earlier and less aggressive interventions."
Learn more about The Virginia Spine Institute on their award-winning website and The Spinal Research Foundation.
Read other coverage on spine surgery research:
- Spine Surgery Research Update: Biologics in Spine Surgery
- Spine Patient Outcomes Research Trial: Surgery Better for Appropriately Indicated Patients
- Spine Surgery in 2011 and Beyond: 7 Points About the Future of Spine Surgery
1. Stem cells. Spine surgeons and basic science researchers alike are exploring the different ways to use stem cells in the treatment of spinal disorders. Some spine surgeons are using stem cells to try to improve fusion procedures and promote disc regeneration. The stem cells used in these procedures aren't embryonic stem cells, but adult allograft stem cells that can be harvested from the patient's own body or donated from another person. "There is a huge misconception about stem cells because patients assume that we are using fetal cells," says Dr. Subach. "Some people, understandably, have moral objections to the use of such cells. In most cases, we are able to utilize the patient's own stem cells circulating in the bloodstream or from their own bone marrow. We have even begun to use allograft stem cells from adult tissue donors. The preliminary results are very exciting."
2. Platelet-rich plasma. Several areas in orthopedics are exploring the use of platelet-rich plasma (PRP) injections to promote healing of tendinopathies and promote joint regeneration. So far, such injections have been proven effective for patients with tennis elbow and plantar fasciitis, but little has work has been done in the spine. To create the injection, the patient's blood is drawn and spun in a centrifuge, removing the blood cells and leaving behind only the platelets and the serum. Dr. Subach's team has explored the use of PRP in the treatment of degenerating lumbar discs using various carriers. "Our research shows that injecting PRP into a disc space can be helpful, but it clears quickly from the disc space," says Dr. Subach. "We are researching ways to inject it into the disc with carriers that allow for a sustained release, allowing for maximum benefit from the PRP. In cases of degeneration, we hope to see a significantly increased benefit with prolonged exposure to PRP."
3. Genetic research. Spine researchers are now looking for a genetic basis for spinal diseases and disorders. For this research, families who have degeneration of the spine are examined to see if there are genetic indicators for the degeneration. If a genetic pattern for spinal degeneration is found, patients with that pattern can be identified and begin treatment presumably before the degeneration occurs. "We've already figured out how to fix the spinal problems that occur," says Dr. Subach. "Now, our focus at The Spinal Research Foundation is looking at ways to identify the genetic basis of spinal disease to find the patients at risk before they become symptomatic. We are screening large numbers of patients with familial disease. This should hopefully allow for earlier and less aggressive interventions."
Learn more about The Virginia Spine Institute on their award-winning website and The Spinal Research Foundation.
Read other coverage on spine surgery research:
- Spine Surgery Research Update: Biologics in Spine Surgery
- Spine Patient Outcomes Research Trial: Surgery Better for Appropriately Indicated Patients
- Spine Surgery in 2011 and Beyond: 7 Points About the Future of Spine Surgery