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Disc Regeneration with Platelets and Growth Factors

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Platelet-Rich Plasma

Part of the book series: Lecture Notes in Bioengineering ((LNBE))

Abstract

The intervertebral disc is the primary cause if not the contributing factor in the vast majority of cases of back pain. Disc degeneration may start with a circumferential tear of the annulus fibrosus, progressing to a radial tear, herniation, loss of disc height and resorption. Nucleus pulposus cells retain the notochordal cell markers cytokeratin CK-8, -18, and -19 and Galectin-3 and cluster adjacent to areas of disc disruption, indicating an innate capability for disc regeneration. The low number of cells available for disc regeneration (4,000 nucleus pulposus cells/mm3 and 9,000 annulus fibrosus cells/mm3) makes it difficult if not impossible for larger tears to be repaired. Platelet rich plasma (PRP) lysate and bone morphogenic proteins (BMPs) have been shown to augment the intervertebral disc repair process in animal models. Platelets have the ability to recognize, adhere to, pull together and hold disrupted tissues with forces ranging from 29 to 70 nN per platelet. On the basis of these findings, we are conducting a clinical trial of intra-discal PRP injections in humans. Patients and discs are selected on the basis of history and physical examination, magnetic resonance imaging, anesthetic discography, and lack of improvement following physical therapy, epidural and facet injections. At the time of publication, we performed 47 disc injections in 35 patients at one or more levels in the lumbar and thoracic spine with our first cases reaching 1 year follow-up. We describe 5 case examples typifying the positive response seen in approximately two-thirds of the patients.

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Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, University of California Davis, Davis, CA, USA

    Marko Bodor

  2. Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA

    Marko Bodor

  3. Interventional Spine and Sports Medicine, Napa, CA, USA

    Marko Bodor & Andrew Toy

  4. The Orthobiologic Institute, Los Angeles, CA, USA

    Danielle Aufiero

Authors
  1. Marko Bodor
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  2. Andrew Toy
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  3. Danielle Aufiero
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Corresponding author

Correspondence to Marko Bodor .

Editor information

Editors and Affiliations

  1. Research Institute of Sports Medicine, Orthopedics and Regeneration - iMOR, Uberaba, Brazil

    José Fábio Santos Duarte Lana

  2. Department of Biotechnological Processes, University of Campinas, Campinas, Brazil

    Maria Helena Andrade Santana

  3. Department of Orthopaedic and Traumatology, University of Campinas, Campinas, Brazil

    William Dias Belangero

  4. Haematology and Hemotherapy Center, State University of Campinas, Campinas, Brazil

    Angela Cristina Malheiros Luzo

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Bodor, M., Toy, A., Aufiero, D. (2014). Disc Regeneration with Platelets and Growth Factors. In: Lana, J., Andrade Santana, M., Dias Belangero, W., Malheiros Luzo, A. (eds) Platelet-Rich Plasma. Lecture Notes in Bioengineering. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40117-6_14

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  • DOI: https://doi.org/10.1007/978-3-642-40117-6_14

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-40116-9

  • Online ISBN: 978-3-642-40117-6

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