Neurosurgeons Tout Made-to-Order Discs for Spines

Over 40% of adults suffer from chronic back pain. The pain arises typically from some form of damage to the discs that sit in between the vertebrae. A healthy disc gives the spine good mobility and flexibility. When damaged, the disc can cause severe pain.

Overuse, aging, injury from an accident and poor posture are all reasons for damaging the discs. Discs may lose their water content, dry up, degenerate and develop micro-cracks. Sometimes, the walls of the disc may crack open and the inner material may ooze out. This is a herniation. If the disc material slips out far enough to occlude the nerves of the spine, it can cause numbness and even disabling pain in the region that is enervated by that nerve. Sometimes, a disc may simply get compressed resulting in the adjacent vertebrae coming very close to each other and causing severe pain. These problems are very common in the lumbar and cervical regions of the spine.

In some scenarios like a herniation, the body may self-heal by reabsorbing the disc but the process takes several months. There is no treatment for some other disc problems. Many people get away from disabling bouts of back pain with short periods of rest and physical therapy or pain medication, NSAIDS and steroids and thereafter manage the condition through lifestyle changes.

But in some cases, spine-surgery has been the only fix to relieve people of their pain or numbness. There are different kinds of surgeries depending on the problem. Some herniations can be handled through 'discectomy' where the disc material that pressurizes the nerve is removed and almost instantly the patient experience relief.

But other problems like degenerated discs and compressed discs are treated through 'fusion' - here the damaged disc is removed and the adjacent vertebrae are made to grow and fuse together. In the process, mobility in that region is the spine is lost. Post-surgery recovery takes more than a year, even after which, the patient cannot lead a normal lifestyle.

Now all this could change with a recent breakthrough that looks very promising. Physician-scientists at Weill Cornell Medical College and basic science researchers at Cornell University have bio-engineered intervertebral discs (IVDs) that can eventually be transplanted in the spine of the patient thereby restoring mobility and the normal load-bearing abilities of the spine.

Dr. Härtl, a neurosurgeon harvests certain useful tissues from discs removed from a patient's pine. Dr. Bonassar, an associate from Cornell's biomedical department, isolates cells from the tissue and grows them in an incubator to reproduce the IVD material. A bioengineered scaffold is used to then shape the material into an IVD-shaped implant to be inserted surgically into the patient's spine. Since the disc is made from the patient's own bio-material, the risk of rejection by the patient's body is greatly diminished.

The team has successfully carried out such implants in rats and is expecting to start using the bioengineered discs in human trials soon. So someday in the near future, people can have made-to-order discs for their backs!

http://www.sciencedaily.com/releases/2009/01/090116151648.htm