Continuing medical education and scientific conferences showcase the most recent and greatest in spine research.
These events are attended by surgeons, physicians, and researchers who come together to exchange their knowledge and learn from each other.
Although their meetings are not open to the public, they are available on their websites. Press releases are available that provide a summary of the breakthroughs and detailed papers from presenters.
These are some of the organizations that offer cutting-edge research on spines:
- The North American Spine Society
- The American Association of Neurological Surgeons
- The Congress of Neurological Surgeons
- The American Academy of Orthopedic Surgeons
- International Society for the Advancement of Spine Surgery
- International Spine Intervention Society
- Medline Plus is a website service of both the National Institutes of Health (NIH) and the National Library of Medicine. It references many of these organizations’ findings. Look for the latest news link on the website’s homepage.
Many tissues are involved in the spine. These include nerves, cartilage, and ligaments, as well as muscles, synovial fluid, joint capsules, and discs.
There are many things going on. Each tissue has its own job, but they must all work together. If there is an imbalance between their complex interactions, it can lead to back pain.
Treatment of just one component may not be enough to address the problem. Artificial disc replacement in the lumbar spinal canal has not been the panacea that it was claimed to be.
Patients who had artificial disc replacement experienced facet dysfunction, joint inflammation, or other soft tissue anomalies. These tissues are not addressed by disc replacement and can even make them worse.
Disc Nucleus Replacement and Prosthetic Disc Nucleus (DNR)
The DNR/PDN procedure in Europe is currently under investigation and is not yet approved by the Food and Drug Administration (FDA).
The procedure replaces the problem nucleus with an artificial one, usually an elastic-type material. There are still many kinks to work out. It was difficult to hold the artificial disc in place while allowing it to move like a natural one.
Surgeons must make a hole in the skin and then plug it. Another challenge was finding a material that could seal the hole while being flexible.
It is generally agreed that natural tissue should be preserved if it is not diseased. Researchers have sought to replace the entire innermost part of the intervertebral disk, known as the nucleus pulposus.
This is the complex job of absorbing the shocks of movement in your spine. This is the part that can become degenerate, lose its fluid, or bulge out, impinging nerves and causing back pain.
This would allow surgeons to preserve the outer disc, made mostly of ligament, that connects the two vertebrae together.
Facet replacement
Like any other joints in the body that can become degenerated due to trauma, repetitive stress, or arthritis, facet joints can also be affected by trauma, repetitive stress, and/or repetitive stress.
Facet-joint dysfunction can cause nerve pinching and back pain. Facet-joint replacement can be used as a replacement for fusion. Patients will have more mobility and less stress on their neighboring vertebrae. This is an issue with fusion.
The FDA is currently evaluating the facet replacement system ACADIA. The facet replacement device ACADIA is a joint reconstruction device that matches the shape and size of the facet joints. It provides relief for back pain, normal motion, and stability.
A clinical trial was underway to evaluate the effectiveness of this device in lumbar spinalstenosis. At the time of publication, two other similar devices were still in development.
Stem Cells
The National Institutes of Health was the first to attempt bone stem cell repair of malformed and damaged bones in 2010.
A team of researchers used mice to pinpoint the locations of bone-generating stem cell sites in the spine, ends of the shins, and other bones. Researchers also identified factors that regulate stem cell growth.
This allows researchers to discover ways to harness stem cells to help repair bone fractures, such as the spine, according to Alan E. Guttmacher (M.D.), acting director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
The XCell-Center in Düsseldorf, Germany released encouraging results from a follow-up study on 140 spinal-cord injury patients who were treated with bone marrow cells in 2010.
More than half the patients experienced improvement after the treatment. Many patients felt some sensation in their hands, feet, and trunks. Also, endurance and muscle strength improved. The bone marrow cells from patients are taken and injected into the spinal fluid.
This center is the first European clinic to offer regenerative medicine with bone marrow stem cell therapy. Although the results look promising, validation is still needed.
Most patients recover from injuries on their own without stem cell therapy. It will be difficult to show their effectiveness by comparing them to a placebo in a clinical study.
Stem cells have great potential to treat chronic diseases, but the genetic and growth factors required to produce them are complicated. This makes it even more difficult to harness and manage this growth.
Remember that tumors are formed from cells that have lost the ability to self-regulate. Cancer is caused by uncontrolled cell growth. Unintentional or undesirable outcomes can result from experimental stem cell growth, such as scarring and matting of nerve fibers.
Thirty-Two Channels of Spinal-Cord Stimulation
As a treatment for chronic back pain, we’ve mentioned spinal-cord stimulation. These devices, like most electronic and computerized things, are getting smaller, smarter, and more sophisticated.
The number of stimulators available at the time this article was published was 16 contacts or electrodes. These stimulators could be doubled in capacity, similar to how computers have more memory and expanded capabilities.
Deep-Brain and Cortical Stimulation
Already, patients with Parkinson’s disease have seen remarkable improvements in their function due to electrodes implanted deep inside the brain.
Similar devices are being studied to block back pain perception at the brain level and to improve consciousness. The same goes for electrodes that are placed on the brain’s surface.
They can also reduce back pain perception in a way that is more specific than what can be done in the spinal cord.
Experimental Treatments in Other Countries
Many patients seek out spine care abroad in the hope of receiving the most up-to-date treatment. While this may offer the best technology, there are risks and complications that can occur. Also, local doctors often don’t want to follow up with foreign specialists.
Many of the experimental treatments are just that—experimental—often with less rigid study designs and shorter follow-up than those used by more conservative regulatory agencies such as the FDA.
The FDA takes a long time to approve new techniques. Medicare and most insurance companies move even slower. Most techniques that have been a huge success worldwide are easily and quickly adopted.
Do your research before you decide to move forward. Ask for referrals from other patients who have undergone the procedure. Talk to other patients who have had the procedure. Also, make sure you know if there is a doctor nearby who can help you if you need it.
Are Clinical Trials Right For You?
Researchers go through rigorous testing to determine if medicine or treatment works on a variety of people. Researchers move on to clinical trials after completing animal and other studies.
These trials test the effectiveness of a treatment on humans. Every trial is guided by a specific protocol. Each study has a detailed plan detailing what the researchers will do. The FDA regulates these trials in the United States.
These studies and regulations are intended to protect patients. A humanitarian clause is used to end a study if it shows remarkable results or great promise. This allows all patients to be eligible for the treatment.
How To Find And Qualify For Clinical Trials
Clinicaltrials.gov is a good place to search for clinical trials. You can search for topics like diseases, conditions, or trial locations. There are likely to be hundreds of studies about back pain at any one time. You can research anything, from meditation’s effects on back pain to the effectiveness and safety of new pain drugs.
To be eligible for a study, you will need to meet the eligibility requirements. You may need to be at least 18 years old, have a valid medical condition, and not be taking any medications.
While some studies are looking for healthy candidates, others seek out people who have specific conditions or diseases. Researchers report on the progress and results of clinical trials to government agencies, medical journals, and scientific meetings. Participation in trials is confidential. Reports do not include names.
Contact the research team if you’ve found a trial that interests you.
Ask questions about specific trials. These are questions that the National Institutes of Health recommends you ask:
- Researchers believe that the experimental treatment is likely to be successful. Is it a previous experiment?
- What types of experiments and treatments are involved?
- What are the potential side effects and risks of the study compared to my current treatment?
- What might the trial do to my everyday life?
- Who will pay for the cost of back pain treatment?
- What about other expenses?
- Which type of long-term care is included in this study?
- How do I know if the experimental treatment works?
- When I receive the results of the trials?
The Risks And Benefits Of Clinical Trials
Participating in a clinical study has many benefits. You have access to the most recent medical treatments, and you can get top-quality medical care at the best healthcare facilities. Contributing to medical research will also help you.
There are also risks. These treatments are still being tested. These treatments may or might not work and may have unexpected side effects. If you are part of a clinical trial to test medications, you might be given a placebo (a tablet with inactive ingredients), meaning you won’t receive the drug.
It is up to you to decide whether or not you want to participate. Talking about it with family members, friends, and your health-care providers can be helpful. It is better to be informed before signing up. You can always cancel your trial at any moment.
Summary
- Some back conditions can be treated with stem cell therapy.
- There are lots of different clinical trials looking for candidates to test new back pain medicines and treatments.
- Clinical trials can have risks and benefits.
Sources:
- Deep Brain Stimulation. (2006, January 1). PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4518728/.
- Coverage – Boston Scientific. (n.d.). www.bostonscientific.com. https://www.bostonscientific.com/en-US/products/spinal-cord-stimulator-systems/precision_spectra/coverage.html.
- L. (n.d.). Leading Hospitals, Clinics, Medical Centers | XCell-Center for Stem Cell Therapy | German Medical Online. Leading Hospitals, Clinics, Medical Centers | XCell-Center for Stem Cell Therapy | German Medical Online. http://german-medical-online.com/XCell-Center-for-Stem-Cell-Therapy.html.
- Bone Or Cartilage: How Stem Cells Repair Bone Fractures | Harvard Stem Cell Institute (HSCI). (2020, February 27). Bone or cartilage: how stem cells repair bone fractures | Harvard Stem Cell Institute (HSCI). https://hsci.harvard.edu/news/bone-cartilage-van-gastel-2020.
- A Pivotal Study Of a Facet Replacement System To Treat Spinal Stenosis – Full Text View – ClinicalTrials.gov. (n.d.). A Pivotal Study of a Facet Replacement System to Treat Spinal Stenosis – Full Text View – ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT00401518.
- DASCOR™ Disc Nucleus Replacement Study – DISC – Desert Institute for Spine Care – Phoenix, AZ – Gilbert, AZ – Scottsdale AZ – East Valley. (2011, November 22). DISC – Desert Institute for Spine Care – Phoenix, AZ – Gilbert, AZ – Scottsdale AZ – East Valley. https://www.sciatica.com/clinical-trials/dascor-disc-nucleus-replacement-study/.