The use of mesenchymal stem cells in the treatment of vertebral diarthroses degeneration (Facet Syndrome)
The standard therapy of Facet Syndrome includes physical therapy, steroid injection or even surgical treatment. Tissue engineering offers us the choice of using Mesenchymal Blast Cells that act over the vertebral diarthroses by regenerating the joint cartilage. It is widely accepted that using blast cells helps many patients suffering from pain due to spinal trauma. When the weight bearing surfaces of the spine change, e.g. due to exaggerated lordosis, Facets get injured and pain emerges. While we can use steroid injection in treating these patients, its painkilling capacity wears off over a period of 6 months approximately, then the pain reemerges more strongly. Using mesenchymal stem cells to treat Facet Syndrome is helpful only in the case that the balance axis of the body and spine remains intact in coronal and sagittal level.
Moving towards this need, mesenchymal stem cells injection has been used in patients resulting in Facet cartilage regeneration. The ability of mesenchymal stem cells to reduce the body’s inflammatory response mainly by inhibiting the action of macrophages is well known. They can also stimulate anabolic pathways by secreting certain substances. After being injected intra-articularly and with the help of synovial fluid, they act directly over cartilage defects, thus restoring them.
There is the question of which is the best site for harvesting mesenchymal stem cells. The first tissue to be examined was bone marrow, which easily differentiates into cartilage. On the other hand, mesenchymal stem cells taken from the fat require an easier procedure like aspiration or small incision, and suffice for the needs of several Facets. In any case, whether taken from the fat or the bone marrow, mesenchymal stem cells have justified their place in the treatment of Facet Syndrome. Further experimental and clinical trials are required in order to shed light on every possible aspect of this novel and pioneering therapy.
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