At the Spinal Cord Clinic we work by the principles of regenerative medicine. Following this and our ethical code, we only apply and recommend the use of stem cells if there is a clear scientific rational for the specific case and disease. A rational can come from guide lines, clinical trials, pre-clinical trials or a strong scientific rational always weighted against risk and safety associated. Literature research for the latest scientific literature can be seen below.
References and Literature – Stem Cell-based Therapies for Back Pain and Spinal Conditions
 Zeckser, J., Wolff, M., Tucker, J., & Goodwin, J. (2016). Multipotent Mesenchymal Stem Cell Treatment for Discogenic Low Back Pain and Disc Degeneration, 2016, 4–6.
 Baglio, Serena Rubina, Dirk Michiel Pegtel, and Nicola Baldini. “Mesenchymal stem cell secreted vesicles provide novel opportunities in (stem) cell-free therapy.” Frontiers in physiology 3 (2012): 359.
 Richardson, Stephen M., et al. “Mesenchymal stem cells in regenerative medicine: focus on articular cartilage and intervertebral disc regeneration.” Methods 99 (2016): 69-80.
 Strassburg, Sandra, et al. “Bi-directional exchange of membrane components occurs during co-culture of mesenchymal stem cells and nucleus pulposus cells.” PLoS One 7.3 (2012): e33739.
 K. A. Pettine, M. B. Murphy, R. K. Suzuki, and T. T. Sand, “Percutaneous lumbar intradiscal injection of autologous bone marrowconcentrated cells significantly reduces discogenic pain through 12 months,” Stem Cells, vol. 33, no. 1, pp. 146–156, 2015.
 Mesoblast Reports Positive 24 Month Results in Phase 2 Trial for Chronic Low Back Pain and Initiation of the Phase 3 Program at JP Morgan Healthcare Conference, January 2015, http://www.mesoblast.com.  N. Bogduk, C. Aprill, and R. Derby, “Lumbar discogenic pain: state-of-the-art review,” Pain Medicine, vol. 14, no. 6, pp. 813– 836, 2013.
 M. J. DePalma, J. M. Ketchum, and T. R. Saullo, “Etiology of chronic low back pain in patients having undergone lumbar fusion,” Pain Medicine, vol. 12, no. 5, pp. 732–739, 2011.
 J. C. Iatridis, S. B. Nicoll, A. J. Michalek, B. A. Walter, and M. S. Gupta, “Role of biomechanics in intervertebral disc degeneration and regenerative therapies: what needs repairing in the disc and what are promising biomaterials for its repair?” Spine Journal, vol. 13, no. 3, pp. 243–262, 2013.
 N. Bogduk, Practice Guidelines for Spinal Diagnostic and Treatment Procedures, International Spine Intervention Society, San Diego, Calif, USA, 2nd edition, 2013.
 K. M.Malik, S. P.Cohen,D. R.Walega, and H. T. Benzon, “Diagnostic criteria and treatment of discogenic pain: a systematic review of recent clinical literature,” The Spine Journal, vol. 13, no. 11, pp. 1675–1689, 2013.
 U. G. Longo, N. Papapietro, S. Petrillo, E. Franceschetti, N. Maffulli, and V.Denaro, “Mesenchymal stem cell for prevention and management of intervertebral disc degeneration,” Stem Cells International, vol. 2012, Article ID 921053, 7 pages, 2012.
 H. T. J. Gilbert, J. A. Hoyland, and S. M. Richardson, “Stem cell regeneration of degenerated intervertebral discs: current status (Update),” Current Pain and Headache Reports, vol. 17, article 377, 2013.
 H. J. Braun, N. Wilcox-Fogel, H. J. Kim, M. A. Pouliot, A. H. S. Harris, and J. L. Dragoo, “The effect of local anesthetic and corticosteroid combinations on chondrocyte viability,” Knee Surgery, Sports Traumatology, Arthroscopy, vol. 20, no. 9, pp. 1689–1695, 2012.
 J. L. Dragoo, C. M. Danial, H. J. Braun, M. A. Pouliot, and H. J. Kim, “The chondrotoxicity of single-dose corticosteroids,” Knee Surgery, Sports Traumatology, Arthroscopy, vol. 20, no. 9, pp. 1809–1814, 2012.
 B. Peng, X. Pang, Y.Wu, C. Zhao, and X. Song, “A randomized placebo-controlled trial of intradiscal methylene blue injection for the treatment of chronic discogenic lowback pain,” Pain, vol. 149, no. 1, pp. 124–129, 2010.
 S.-H. Kim, S.-H. Ahn, Y.-W. Cho, and D.-G. Lee, “Effect of intradiscal methylene blue injection for the chronic discogenic low back pain: one year prospective follow-up study,” Annals of Rehabilitation Medicine, vol. 36, no. 5, pp. 657–664, 2012.
 W. Yin, K. Pauza, W. J. Olan, J. F. Doerzbacher, and K. J. Thorne, “Intradiscal injection of fibrin sealant for the treatment of symptomatic lumbar internal disc disruption: results of a prospective multicenter pilot study with 24-month follow-up,” Pain Medicine, vol. 15, no. 1, pp. 16–31, 2014.
 S.-Z. Wang, Y.-F. Rui, Q. Tan, and C. Wang, “Enhancing intervertebral disc repair and regeneration through biology: plateletrich plasma as an alternative strategy,” Arthritis Research & Therapy, vol. 15, no. 5, article 220, 2013.
 G. B. Gullung, W. Woodall, M. Tucci, J. James, D. Black, and R. McGuire, “Platelet-rich plasma effects on degenerative disc disease: analysis of histology and imaging in an animal model,” Evidence-Based Spine-Care Journal, vol. 2, no. 4, pp. 13–18, 2011.
 Y.A.Tuakli-Wosornu, A. Terry, K. Boachie-Adjei et al., “Lumbar intradiskal platelet-rich plasma (PRP) injections: a prospective, double-blind, randomized controlled study,” PM&R, 2015.
 L. Manchikanti, F. J. E. Falco, R. M. Benyamin et al., “An update of the systematic assessment of mechanical lumbar disc decompression with nucleoplasty,” Pain Physician, vol. 16, no. 2, pp. SE25–SE54, 2013.
 V. Singh, L. Manchikanti, A. K. Calodney et al., “Percutaneous lumbar laser disc decompression: an update of current evidence,” Pain Physician, vol. 16, no. 2, pp. 229–260, 2013.
 D. H. Jo and H. J. Yang, “The survey of the patient received the epiduroscopic laser neural decompression,” The Korean Journal of Pain, vol. 26, no. 1, pp. 27–31, 2013.
 W. C. H. Jacobs, S. M. Rubinstein, P. C. Willems et al., “The evidence on surgical interventions for low back disorders, an overviewof systematic reviews,” European Spine Journal, vol. 22, no. 9, pp. 1936–1949, 2013.
 W. Shohei, Y. Kuroda, F. Ogura, T. Shigemoto, and M. Dezawa, “Regenerative effects of mesenchymal stem cells: contribution of muse cells, a novel pluripotent stem cell type that resides in mesenchymal cells,” Cells, vol. 1, no. 4, pp. 1045–1060, 2012.
 P. Ghosh, R.Moore, B. Vernon-Roberts et al., “Immunoselected STRO-3+ mesenchymal precursor cells and restoration of the extracellular matrix of degenerate intervertebral discs: laboratory investigation,” Journal of Neurosurgery: Spine, vol. 16, no. 5, pp. 479–488, 2012.
 C. J. Centeno, “Clinical challenges and opportunities of mesenchymal stem cells in musculoskeletal medicine,” PM&R, vol. 6, no. 1, pp. 70–77, 2014.
 A. Cond´e-Green, R. L. Rodriguez, S. Slezak, D. P. Singh, N. H. Goldberg, and J. Mclenithan, “Comparison between stromal vascular cells’ isolation with enzymatic digestion and mechanical processing of aspirated adipose tissue,” Plastic and Reconstructive Surgery, vol. 134, no. 4, p. 54, 2014.
 L.-L. Lu, Y.-J. Liu, S.-G. Yang et al., “Isolation and characterization of human umbilical cord mesenchymal stem cells with hematopoiesis-supportive function and other potentials,” Haematologica, vol. 91, no. 8, pp. 1017–1026, 2006.
 H. Brisby, N. Papadimitriou, C. Brantsing, P. Bergh, A. Lindahl, and H. Barreto Henriksson, “The presence of local mesenchymal progenitor cells in human degenerated intervertebral discs and possibilities to influence these in vitro: a descriptive study in humans,” Stem Cells and Development, vol. 22, no. 5, pp. 804– 814, 2013.
 M. Tanaka, D. Sakai, A. Hiyama et al., “Effect of cryopreservation on canine and human activated nucleus pulposus cells: a feasibility study for cell therapy of the intervertebral disc,” BioResearch Open Access, vol. 2, no. 4, pp. 273–282, 2013.
 D. Coric, K. Pettine, A. Sumich, and M. O. Boltes, “Prospective study of disc repair with allogeneic chondrocytes,” Journal of Neurosurgery: Spine, vol. 18, no. 1, pp. 85–95, 2013.
 H. J.Meisel, V. Siodla, T. Ganey, Y.Minkus, W. C. Hutton, and O. J. Alasevic, “Clinical experience in cell-based therapeutics: disc chondrocyte transplantation: a treatment for degenerated or damaged intervertebral disc,” Biomolecular Engineering, vol. 24, no. 1, pp. 5–21, 2007.
 T. Miyamoto, T. Muneta, T. Tabuchi et al., “Intradiscal transplantation of synovial mesenchymal stem cells prevents intervertebral disc degeneration through suppression of matrix metalloproteinase-related genes in nucleus pulposus cells in rabbits,”Arthritis Research&Therapy, vol. 12,no. 6, articleR206, 2010.
 S. Strassburg, S. M. Richardson, A. J. Freemont, and J. A. Hoyland, “Co-culture induces mesenchymal stem cell differentiation and modulation of the degenerate human nucleus pulposus cell phenotype,” Regenerative Medicine, vol. 5, no. 5, pp. 701–711, 2010.
 Z. Sun, Z.-H. Liu, X.-H. Zhao et al., “Impact of direct cell cocultures on human adipose-derived stromal cells and nucleus pulposus cells,” Journal of Orthopaedic Research, vol. 31, no. 11, pp. 1804–1813, 2013.
 X. Li, J. P. Lee, G. Balian, and D. G. Anderson, “Modulation of chondrocytic properties of fat-derivedmesenchymal cells in cocultures with nucleus pulposus,”Connective Tissue Research, vol. 46, no. 2, pp. 75–82, 2005.
 C. LeVisage, S.W.Kim,K.Tateno, A.N. Sieber, J.P.Kostuik, and K. W. Leong, “Interaction of human mesenchymal stem cells with disc cells: changes in extracellular matrix biosynthesis,” Spine, vol. 31, no. 18, pp. 2036–2042, 2006.
 A.W. H. Gebraad, S. Miettinen, D.W. Grijpma, and S. P.Haimi, “Human adipose stem cells in chondrogenic differentiation medium without growth factors differentiate towards annulus fibrosus phenotype in vitro,” Macromolecular Symposia, vol. 334, no. 1, pp. 49–56, 2013.
 K.Wuertz, K. Godburn, C. Neidlinger-Wilke, J. Urban, and J. C. Iatridis, “Behavior of mesenchymal stem cells in the chemical microenvironment of the intervertebral disc,” Spine, vol. 33, no. 17, pp. 1843–1849, 2008.
 D. Sakai, J. Mochida, T. Iwashina et al., “Regenerative effects of transplanting mesenchymal stem cells embedded in atelocollagen to the degenerated intervertebral disc,” Biomaterials, vol. 27, no. 3, pp. 335–345, 2006.
 V. Y. L. Leung, D.M. K. Aladin, F. Lv et al., “Mesenchymal stem cells reduce intervertebral disc fibrosis and facilitate repair,” Stem Cells, vol. 32, no. 8, pp. 2164–2177, 2014.
 L. Orozco, R. Soler, C. Morera, M. Alberca, A. S´anchez, and J. Garc´ıa-Sancho, “Intervertebral disc repair by autologous mesenchymal bonemarrowcells: a pilot study,” Transplantation, vol. 92, no. 7, pp. 822–828, 2011.
 Mesoblast Limited, “Positive Spinal Disc Repair Trial Results Using Mesoblast Adult Stem Cells,” 2014, http://www.globenewswire. com/.
 A. Colombini, C. Ceriani, G. Banfi, M. Brayda-Bruno, and M. Moretti, “Fibrin in intervertebral disc tissue engineering,” Tissue Engineering Part B: Reviews, vol. 20, no. 6, pp. 713–721, 2014.
 B. R.Whatley and X.Wen, “Intervertebral disc (IVD): structure, degeneration, repair and regeneration,” Materials Science & Engineering C, vol. 32, no. 2, pp. 61–77, 2012.
 Y. Wang, Z.-B. Han, Y.-P. Song, and Z. C. Han, “Safety of mesenchymal stem cells for clinical application,” Stem Cells International, vol. 2012,Article ID 652034, 4 pages, 2012.
 G.Vadal’a, G. Sowa,M.Hubert, L. G.Gilbertson,V.Denaro, and J. D. Kang, “Mesenchymal stem cells injection in degenerated intervertebral disc: cell leakage may induce osteophyte formation,” Journal of Tissue Engineering and Regenerative Medicine, vol. 6, no. 5, pp. 348–355, 2012.
 W.-H. Chen, H.-Y. Liu, W.-C. Lo et al., “Intervertebral disc regeneration in an ex vivo culture system using mesenchymal stem cells and platelet-rich plasma,” Biomaterials, vol. 30, no. 29, pp. 5523–5533, 2009.
 Y. Zhu, M. Yuan, H. Y. Meng et al., “Basic science and clinical application of platelet-rich plasma forcartilage defects and osteoarthritis: a review,” Osteoarthritis and Cartilage, vol. 21, no. 11, pp. 1627–1637, 2013.
 C. S. Lee,O. A. Burnsed,V. Raghuram, J.Kalisvaart, B.D. Boyan, and Z. Schwartz, “Adipose stem cells can secrete angiogenic factors that inhibit hyaline cartilage regeneration,” Stem Cell Research &Therapy, vol. 3, no. 4, article 35, 2012.
 T. E. Foster, B. L. Puskas, B. R. Mandelbaum, M. B. Gerhardt, and S. A. Rodeo, “Platelet-rich plasma: from basic science to clinical applications,” The American Journal of Sports Medicine, vol. 37, no. 11, pp. 2259–2272, 2009.
 A. S.Wasterlain, H. J. Braun, A. H. S. Harris, H.-J. Kim, and J. L. Dragoo, “The systemic effects of platelet-rich plasma injection,” The American Journal of Sports Medicine, vol. 41, no. 1, pp. 186– 193, 2013.