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Chronic back pain, stem cell transplant to cure it


May 20, 2021

Treat chronic back pain with an autologous stem cell transplant. After years of research, the team led by Vincenzo Denaro, with Gianluca Vadalà and Fabrizio Russo, performed the first Italian transplants of autologous stem cells, i.e. taken from the same patient, at the Campus Bio-Medico University Hospital in Rome. And now the experimentation starts within the Active project funded by the Department of Medicine, Epidemiology, Occupational and Environmental Hygiene (Dimeila) of Inail. 52 patients of working age, from 18 to 65 years old, with pathologies of the intervertebral discs, the shock absorbers placed between the vertebrae capable of supporting all loads, mainly working and sports, will be recruited. Back pain is a disease that affects 97% of the population. According to the Global Pain Index it is estimated that in Italy 6 out of 10 people suffer from it every week, at home as well as in the workplace. At the base of the most common diseases affecting the spinal column (low back pain, sciatica, slipped slipped disc, deformity) there is an initial damage to the intervertebral disc visible early through magnetic resonance imaging. The goal of autologous stem cell transplantation “is the regeneration of damaged intervertebral discs”, explain the doctors. The surgical technique used, in experimentation for over 15 years at the Campus Bio-Medico University of Rome, “is now successfully performed on ‘man for the first time in Italy. The experiments carried out so far have shown the absence of side effects. The benefits on the clinical picture of the patient manifest themselves already one month after surgery with a significant reduction in pain “, highlights Campus Bio – Doctor. “Our stem cell experiments started more than 15 years ago – emphasizes Denaro, emeritus head of Orthopedics at the Campus Bio-Medico University Hospital – We were part of a European program for the regeneration of the disc of which University Campus Bio-Medico of Rome was the only Italian center involved and in which we gained experience on 18 patients transplanted with allog cells eniche, i.e. coming from a donor. Based on this experience, we moved on to using autologous cells. Today we are starting the last phase of this long research path carried out together with Inail, which focuses on the development of personalized regenerative medicine applied to diseases of great diffusion and social impact “.” This advanced therapy, currently not yet used in clinical context – observes Vadalà, doctor of the Orthopedics and Traumatology Unit of the Campus Bio-Medico University Hospital and researcher in diseases of the musculoskeletal system – uses autologous mesenchymal cells present within the bone marrow, taken from the iliac crest of the same individual. The bone marrow blood is sent to the Cell Factory of the Irccs Ca ‘Granda Foundation Ospedale Maggiore Policlinico in Milan, partner of the project, where the cells are isolated and multiplied up to an ideal number to promote regeneration “. Over time – they recall the doctors – the intervertebral discs, about 6 millimeters high and composed of a nucleus pulposus rich in more than 80% of water, tend to collapse and lose their contents causing that often disabling spinal pain. The transplanted stem cells stimulate the production of substances that rehydrate the discs, also obtaining the effect of extinguishing the inflammatory process responsible for pain. The original level of cushioning of the intervertebral disc is thus restored, restoring the original elasticity that eliminates chronic pain. “It is as if these cells restored life to the damaged disc – explains Russo, orthopedist of the Campus Bio-Medico – making it come back the tissue from degenerated to healthy and restoring the biological shock-absorbing capacity. In the case of intervertebral discs the result is even more significant “. Currently there is no therapy capable of restoring the function of the degenerated intervertebral disc. To date, chronic cases are often treated conservatively with anti-inflammatory drugs and physiokinesitherapy, but above all surgically, by removing the disc which further weakens the shock absorbing system and with spinal stabilization treatments when the vertebrae deform or slip. These stabilizations, precisely due to the suppression of a movement hinge, can lead the problem to recur. The project represents an important challenge also for the National Institute for Accident Insurance at Work, which has always dealt with work reintegration and believes in collaboration with the orthopedic world, as Sergio Iavicoli, director of Dimeila Inail points out: “This project is characterized by a multidisciplinary approach. We want to create a supply chain between all the subjects that follow the patient-worker and use the new technologies and the most advanced methods of care. In this sense, collaborating with specialized centers such as the Orthopedics of the Campus Bio-Medico University Hospital is essential “. In Italy, according to the Global Burden of Disease 2019, musculoskeletal pathologies are the first cause of occupational disease, growing by 88 % from 2010 to 2017 (from 19,912 to 37,450 cases). As regards low back pain, it is estimated that 60% of all workers suffer from it during their career: a disease that becomes chronic in 10% of cases. professional accounts for about 33% of all health care and social security / insurance expenses for workers, for an estimated cost of € 7.9 billion in the last year alone. Furthermore, with the progressive extension of working life, this problem will always result more accident. “We are a country characterized by a population with an advanced average age – remarked Iavicoli – Many people leave the world of work early or increase their absences because they deal late with diseases such as those of the spine, causing concrete damage to their companies. This pilot project takes care of the person as a whole, not just as a worker, following him for a long period after the surgery to treat back pain and at the same time increase the working capacity. We want to arrive at a new protocol and for this we are looking for patients with these problems interested in participating. All the services carried out at the Campus Bio-Medico University Hospital will be free “. The orthopedists of the Bio-Medico Campus will then move on to monitoring the results over time. One year after the operation, the disappearance of chronic pain will be measured, combining clinical checks with magnetic resonance exams To apply for the trial it is necessary to send an email with your data to the address [email protected]

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