Table 5.
Clinical trials using mesenchymal stem cells for chronic discogenic low back pain.
| Year, Author | Stem Cells | Cell Number | Case No. |
FU (Months) | Finding |
|---|---|---|---|---|---|
| 2011 Orozco L et al. [35] |
Autologous BM | 23 ± 5 × 106 | 10 | 12 | VAS, ODI Improvement in VAS, ODI; improvement of water content on MRI |
| 2013 Pang et al. [47] |
Umbilical Cord Mesenchymal Stem Cells | 2 | 24 | The VAS and ODI scores decreased obviously during a 2-year follow-up period | |
| 2014 Pettine KA et al. [40] |
Autologous BM concentrate | 121 × 106 total nucleated cell/ml | 26 | 12 | Improvement in VAS, ODI. Hgher concentration MSC injection patients versus lower concentration. Improvement of at least 1 grade in Modified Pfirrmann Score in 8 of 20 at 12 months |
| 2015 Pettine KA et al. [44] |
Autologous BM concentrate | 121 × 106 total nucleated cell/ml | Same cohort as above |
24 | Reduction in ODI and VAS scores endured at 24 months |
| 2017 Pettine KA et al. [45] |
Autologous BM concentrate | 121 × 106 total nucleated cell/ml | Same cohort as above |
36 | Reduction in ODI and VAS scores endured at 36 months |
| 2015 Mochida J et al. [41] |
Coculture of NP cells with autologous BM | Activated NP cells: 106 | 9 | 36 | JOA scoring system improvement. No injected disc showed worsening degeneration on MRI. |
| 2016 Elabd et al. [42] |
Autologous bone marrow-derived MSCs | 15.8–37.3 × 106 cells/ disc |
5 | 48–72 | No adverse events related to MSC Injection. Majority reported an overall improvement in QoL, strength, and mobility. Effect independent of cell dose |
| 2017 Kumar et al. [16] | Autologous ASCs in HA carrier | 2 × 107
4 × 107 |
10 | 12 | Improvement in VAS, ODI, SF-36 (n = 6); improvement of water content on diffusion MRI (n = 3) |
| 2017 Noriega DC et al. [46] |
Allogenic BM MSCs | 25 × 106 | 24 Cohort study with control group |
12 | Improvement in VAS and ODI. Improvement in Pfirrmann disc degeneration grade at 12 months |
| 2017 Centeno et al. [43] |
autologous bone marrow-derived MSCs | 2.3 × 107 cells/disc range 1.73–45 × 106 |
33 | 72 | Improvement in NPS, FRI scores. |
| 2021 Amirdelfan et al. [37] | Allogenic MPCs in HA carrier | 6 × 106 1.8 × 107 |
100 | 36 | Improvement in VAS, ODI, SF-36, Work Productivity and Activity Index MRI |
| 2022 Bates et al. [38] | Autologous ASCs | 1 × 107 | 9 | 12 | Improvement in pain (78%); Increased work capacity (56%); Reduced analgesic medication (33%); Improvements in EQ-5D and ODI, |
| 2022 Atluri et al. [39] |
Autologous BM-MSCs | 2.1 × 106 | 80 | 12 | Improvement in ODI, pain, and other parameters (EQ-5D-3L, GMH, and GPH). |
| Present study | Autologous ASCs spheroids with matrillin-3-priming | 6 × 106 | 8 | 6 | Improvement in VAS and ODI Improvement in MRI: reduction of hyperintensity zone and central disc protrusion |
FU: follow-up; M: months; No: number; ASC: adipose-derived mesenchymal stem cell; BM-MSC: bone marrow-derived mesenchymal stem cell; MPC: mesenchymal precursor cell; HA: hyaluronic acid; VAS: visual analogue scale; ODI: Oswestry Disability Index; SF: Short Form; MRI: magnetic resonance imaging; EQ-5D-3L: EuroQOL 5-Dimensional Questionnaire; QoL: quality of life; FRI:functional rating index; JOA: Japanese Orthopedic Association score; NPS:numeric pain score (0–10, 0 = no pain, 10 = worst possible pain); GMH: Global Mental Health; GPH: Global Physical Health.