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Dr. Jaspal Ricky Singh
Dr. Jaspal Ricky Singh

Q: Can stem cells help prevent degenerative disc disease?

A: The first part of the answer is to address is the phrase “degenerative disc disease.” Many people have read their MRI (medical imaging) reports, and the radiologist often says, “multilevel degenerative disc disease.” We are not fond of using the word “disease” because that’s like saying getting white hair is a disease. It’s not a disease. It’s just part of the aging process. All of us, with time, are going to shrink in height. That is because those thick, white discs that you see in a young spine will gradually turn black and decrease in thickness.

Stem cells are the body’s raw materials — cells with specialized functions. Orthobiologics are a form of regenerative and restorative medicine that uses stem cells to repair damaged cells within the body.

Currently, we treat disc degeneration only if there are symptoms, such as back and leg pain. If we were to get an MRI on everyone on this webinar today, two-thirds of us will probably have some form of disc degeneration but have no symptoms. That’s where the opportunity exists. Stem cells are used to harness the body’s natural healing properties in order to repair and restore tissues that have degenerated.  Stem cell therapy may prevent future degeneration of spinal discs and future symptoms such as back pain.

Dr. Roger Hartl
Dr. Roger Hartl

If we see something on an MRI scan but the patient doesn’t have any pain, we don’t treat it at that point, because the risk-benefit ratio is not there. However, let’s say the patient has a herniated disc. That patient needs an operation because the patient has leg pain and weakness. In this case, there’s no downside to using the power of stem cells to repair a nearby disc showing signs of degeneration. We know statistically that this patient is at risk of developing pain five, ten, or fifteen years down the line from the disc degeneration.

We’re still collecting data, as the use of stem cells to treat spine and joint arthritis is still considered off-label by the FDA. We don’t yet have clinical proof that stem cell therapy works for preventing disc degeneration. Still, as we get more encouraging data that these stem cells can treat disc degeneration and back pain, the next step would be to do just what we’re talking about: offer this as a prophylactic (preventive) treatment in patients who may not even have back pain yet.

Gastroenterologists tell us to come in when we’re 40 or 50 to get a colonoscopy. Cardiologists ask us to get an electrocardiogram (EKG) every once in a while to check out our heart function. In spine health, we don’t do that. We wait for something bad to happen or for symptoms to occur, then the patient comes in to see us, and we intervene. Maybe in the future, we won’t wait that long. Perhaps we’ll get a scan and use stem cell therapy prophylactically to prevent future degeneration. It’s an interesting idea.

Dr. Jaspal Ricky Singh, physical medicine and rehabilitation physician and Dr. Roger Härtl, neurosurgeon

This question was answered during the episode of Spine Time called “Stem Cells for My Spine?” A recording of this webinar held on September 17, 2020, is available on YouTube. To sign up for future episodes of Spine Time, where you can ask questions of our spine specialists, subscribe here.

See more Ask a Spine Doctor columns