Gowriharan "Dr. Ty" Thaiyananthan, MD, neurosurgeon and co-medical director of the Basic Spine Brain & Spine Institute of California discusses five things to know about the use of stem cells in spine surgery.
1. Use of cadaveric stems cells. There are primarily two groups of stem cell products in use for spine, says Dr. Thaiyananthan. One form is cadaveric stems cells used in place of BMP (bone morphogenetic proteins), which was traditionally used in enhanced fusion.
"There are a couple of advantages of using cadaveric stem cells," he says. "First, you can mitigate some of the risks of BMPs. Stem cells aren't as 'potent' so they don't have a lot of the reported side effects of BMP. Second, they also tend to be less expensive overall so it's more cost-effective."
2. Use of mesenchymal stem cells. In additional to using pulled cadaveric stem cells or stem cells from donors, there are devices that will harvest bone morrow and spin down patient's own mesenchymal stem cells — the stem cells that are present in bone marrow — and concentrate it, says Dr. Thaiyananthan.
"You can put those on graft materials," he says. "These grafts are as effective or better for certain spine procedures such as fusions."
3. Mesenchymal stem cell usage on the rise. "We employ a lot of mesenchymal stem cells — we harvest bone marrow in the OR, spin and concentrate it, and then re-implant them in patients" says Dr.Thaiyananthan. "The advantage is you're using something your body already has. You are able to concentrate the useful components and it's extremely effective from a clinical and cost perspective and delivers a really cutting-edge procedure. Whereas BMP can cost upwards of $5,000, spinning down stem cells intraoperatively costs a fraction of that and yield better results."
4. Patients asking for mesenchymal stem cells. Dr. Thaiyananthan says patients are more frequently asking for this type of therapy. "The nice thing about it is it really doesn't involve any extra work, it doesn't prolong the surgical time and it doesn't extend recovery time," he says. "Looking at one year of results for about 200 patients … they've been as good as BMP so it's really promising," he says.
5. Use of stem cells for "traditional" applications several years away. Dr. Thaiyananthan says the usage of stem cells for what people have considered "traditional" applications, such regenerating parts of the spine, are not likely for several years. "There is some work being done on that right now but we're probably at least a decade away, in my opinion, from something that's clinically applicable," he says.
Learn more about Basic Spine Brain & Spine Institute of Southern California.
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