According to the reports of the Chinese surgeons, they have achieved long-term success with the first use of transplanted spinal discs in order to alleviate back pain.
According to the information released by the doctors at the University of Hong Kong and the Naval General Hospital in Bejing, five years ago, spinal discs from human donors were transplanted into five individuals suffering chronic back pain resulting from disc degeneration.
As it was reported in the March 24 issue of The Lancet, the five-year follow-up discovered an improvement in symptoms, no signs of immune rejection and merely gentle degeneration of the transplanted discs.
Too few patients examined
Dr Barth Green, chairman of neurological surgery at the University of Miami Miller School of Medicine, described the breakthrough technique as ‘very creative’. "However, I am convinced that five patients are way too few to find out whether this is going to be the answer for the long run," he explained.
Spinal disc transplants could have a real future, nevertheless, due to the fact that surgeons are not always satisfied with the effects of modern operations, Green explained. When back pain can’t be treated with medicines, a surgical procedure known as fusion is performed, uniting the bones in order to alleviate the pain. Lately, surgeons have began to implant artificial discs in some cases.
"This is aiming at the right direction," Dr Roger Hartl, director of the spine program at New York Presbyterian/Weil Cornell Medical Centre, in New York City, said of the Chinese work. "Biological replacement of a disc rather than fusion surgery or artificial discs are the way to go. In my opinion, the findings are very promising. People have performed this in animals, however the nice thing about this research is that it is the first time it has been carried out in humans."
Hartl is cooperating with biomedical engineers at Cornell University’s main campus in Ithaca, New York, trying to grow replacement discs by the use of cell cultures.
Similarly to Green, he is still careful about the Chinese report, though. "The five-year results look promising, but the numbers are too small to conclude about the potential accelerated degeneration of other discs near the surgical site," he explained.
Another reason for being cautious is that "there is not much information concerning where the patients came from, why they had undergone surgery and where the transplanted specimens came from," Hartl said.
Not enough disks?
Additionally, "it is difficult to imagine now that this will become standard therapy for patients who have degenerative disc disease due to the problem of donation," Hartl added.
Green disagreed with that. "Each hospital in the United States makes use of cadaver bones for spinal surgery," he explained. "Hence, the real question is what the findings are."
It’s too early to say, Green explained. "I don’t think that we are anywhere near ready to begin performing it routinely due to the fact that a lot of significant details have to be figured out."
The Chinese scientists emphasized that some of those details, saying that "improvements in the area of graft preservation, repopulation of the allograft [transplant] with living cells and surgical techniques" are necessary before disc transplants could be suggested for ordinary use.
