Remarkable recovery of lower extremity motor impairment in degenerative disc disease after percutaneous laser disc decompression combined with umbilical cord-derived mesenchymal stem cells implantation: A case report.

Autor:	Rahyussalim AJ; Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo General Hospital, Jakarta 10430, Indonesia; Stem Cell and Tissue Engineering Cluster, IMERI, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; Stem Cell Medical Technology Installation, Cipto Mangunkusumo General Hospital, Jakarta 10430, Indonesia., Andar AA; Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo General Hospital, Jakarta 10430, Indonesia., Canintika AF; Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo General Hospital, Jakarta 10430, Indonesia., Putri DA; Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo General Hospital, Jakarta 10430, Indonesia., Kurniawati T; Stem Cell and Tissue Engineering Cluster, IMERI, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; Stem Cell Medical Technology Installation, Cipto Mangunkusumo General Hospital, Jakarta 10430, Indonesia.
Jazyk:	angličtina
Zdroj:	International journal of surgery case reports [Int J Surg Case Rep] 2024 May; Vol. 118, pp. 109576. Date of Electronic Publication: 2024 Mar 24.
DOI:	10.1016/j.ijscr.2024.109576
Abstrakt:	Introduction and Importance: Degenerative disc disease (DDD) is a common cause of low back pain, often leading to significant discomfort for patients. Current treatment options such as spinal fusion and physical therapy focus on symptom management rather than addressing the underlying degeneration. Percutaneous laser disc decompression (PLDD) has shown efficacy in treating radicular pain associated with disc herniation. However, there is a growing interest in utilizing tissue engineering approaches to reverse the pathological process of DDD. While results in larger vertebrates have been inconsistent, mesenchymal stem cells (MSCs) have demonstrated promise in small animal models. Case Presentation: A 46-year-old male presented with low back pain as well as urinary and fecal incontinence. Magnetic resonance imaging revealed disc bulging and foraminal stenosis at the L2-L4 levels. The patient underwent PLDD combined with umbilical cord-derived mesenchymal stem cells (UC-MSCs) injection, which later resulted in significant pain reduction and improved motor function. At six months of follow-up, the patient reported sustained pain relief and functional improvement. Clinical Discussion: Percutaneous decompression techniques not only substantially reduce intradiscal pressure and facilitate the implosion of herniation inward but also concurrently expedite the degeneration of the intervertebral disc. Therefore, in addition to performing PLDD, stem cell injection is also carried out. This report underscores the importance of integrating mechanical and biological interventions for degenerative disc diseases, suggesting PLDD combined with MSC therapy as a promising strategy for managing DDD and potentially reversing its progression. We found that the patient had decreased pain postoperatively; he no longer complained of pain after six months of follow-up. Conclusion: PLDD combined with UC-MSCs might be an alternative treatment for patients with DDD. In addition to mechanical treatment, biological treatment with MSC injections is believed to be a potent combination for treating degenerative diseases such as DDD. Competing Interests: Declaration of competing interest The authors declare no conflicts of interest. (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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