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      Biologic treatment of mild and moderate intervertebral disc degeneration.

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          Abstract

          Disc degeneration is the most common cause of back pain in adults and has enormous socioeconomic implications. Conservative management is ineffective in most cases, and results of surgical treatment have not yet reached desirable standards. Biologic treatment options are an alternative to the above conventional management and have become very attractive in recent years. The present review highlights the currently available biologic treatment options in mild and moderate disc degeneration, where a potential for regeneration still exists. Biologic treatment options include protein-based and cell-based therapies. Protein-based therapies involve administration of biologic factors into the intervertebral disc to enhance matrix synthesis, delay degeneration or impede inflammation. These factors can be delivered by an intradiscal injection, alone or in combination with cells or tissue scaffolds and by gene therapy. Cell-based therapies comprise treatment strategies that aim to either replace necrotic or apoptotic cells, or minimize cell death. Cell-based therapies are more appropriate in moderate stages of degenerated disc disease, when cell population is diminished; therefore, the effect of administration of growth factors would be insufficient. Although clinical application of biologic treatments is far from being an everyday practice, the existing studies demonstrate promising results that will allow the future design of more sophisticated methods of biologic intervention to treat intervertebral disc degeneration.

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          Author and article information

          Journal
          Mol. Med.
          Molecular medicine (Cambridge, Mass.)
          The Feinstein Institute for Medical Research (North Shore LIJ Research Institute)
          1528-3658
          1076-1551
          Sep 18 2014
          : 20
          Affiliations
          [1 ] Third Department of Orthopaedic Surgery, University of Athens Medical School, KAT Hospital, Athens, Greece.
          [2 ] Department of Biological Chemistry, University of Athens Medical School, Athens, Greece.
          Article
          molmed.2014.00145
          10.2119/molmed.2014.00145
          4212014
          25171110

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