Challenges in the Development of Biological Approaches for the Treatment of Degenerative Disc Disease

• Published in: World neurosurgery Vol. 157; pp. 274 - 281
• Main Authors: Goldberg, Jacob L., Garton, Andrew, Singh, Sunidhi, Kirnaz, Sertac, Sommer, Fabian, Carnevale, Joseph A., Atalay, Basar, Medary, Branden, McGrath, Lynn B., Härtl, Roger
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2022
• Subjects: Animals; Biological disc replacement challenges; Biological Factors - physiology; Biological Products - pharmacology; Biological Products - therapeutic use; Biomechanical Phenomena - physiology; Degenerative disc disease; Extracellular Matrix - drug effects; Extracellular Matrix - physiology; Humans; Intervertebral Disc Degeneration - diagnostic imaging; Intervertebral Disc Degeneration - physiopathology; Intervertebral Disc Degeneration - therapy; Intervertebral disc replacement obstacles; Magnetic Resonance Imaging - methods; Biological disc replacement challenges; DDD; MRI; Intervertebral disc replacement obstacles; IVD; Degenerative disc disease
• ISSN: 1878-8750; 1878-8769; 1878-8769
• DOI: 10.1016/j.wneu.2021.09.067

There are numerous innovative and promising approaches aimed at slowing, reversing, or healing degenerative disc disease. However, multiple treatment-specific impediments slow progress toward realizing the benefits of these therapies. First, the exact pathophysiology underlying degenerative disc disease remains complicated and challenging to study. In addition, the study of the spine and intervertebral disc in animal models is difficult to translate to humans, hindering the utility of preclinical research. Biological treatments are subject to the complex biomechanical environment in which native discs degenerate. The regulatory approval environment for these therapeutics will likely involve a high degree of scrutiny. Finally, patient selection and assessment of outcomes are a particular challenge in this clinical setting.