Biologics
The term “biologics” in the spine world means different things to different people. To a spine patient, it suggests the possibility of receiving a “magical injection” of some high-tech biological elixir to take chronic spine pain away forever. To a doctor, researcher, or clinician, it means an array of new, regenerative technologies that may prevent the need for open spine surgeries, ushering in minimally invasive technologies that are less expensive, less stressful to patients, and hopefully more effective for long-term pain relief.
In 2009, patients saw a dizzying number of new “biologic” treatments announced through press releases, journal articles, and clinical trials. Some therapies are said to be “stand alone,” while others can be based on the culturing a patient’s own cells for regrowth and transplantation. There are different, overlapping versions of how these techniques are helping patients now, ranging from autologous disc chondrocyte transplantation (ADCT) to nucleus regeneration to disc annulus repair. Many of these technologies are in development, with some already available overseas or in US clinical trials.
Other recent spinal treatment techniques are refinements of procedures tried decades ago, with some research going as far back as the 1930s. One technique tried in the 1970s involved the injection of papain (an enzyme from papaya) into the affected spinal disc. While there were many successes, there were also failures that led to the end of these trials. However, new techniques in clinical trials with fibrin-aproptinin solutions have realized hopeful preliminary treatment results. Companies offering these spinal disc injections categorize their products as “interventional spine therapies.”
Stem cell treatment technology has been applied to spine surgeries for several years already in the US, with its first “allogeneic” application in spinal fusions in 2008. Concurrently, stem cell technology as a stand along solution for early cases of disc degeneration has been enthusiastically presented at spinal conferences, but human clinical trials and good results may be years away.
