Becker's ASC Review

34 ORTHOPEDICS Stem cells in spine, orthopedics: 6 notes for surgeons By Alan Condon A landmark clinical trial was announced in November when a $9 million grant was provided for the first human study using stem cells to treat a spinal disorder that occurs in babies in the womb. Becker's Spine Review expanded on this clinical trial and five other stem cell notes from 2020, including insights from leading spine and orthopedic surgeons. 1. e California Institute for Regenera- tive Medicine provided a $9 million grant to fund the first human clinical trial using stem cells to treat spina bifida. e grant was awarded to researchers at UC Davis Health in Sacramento, Calif. Beginning in 2021, the clinical trial will administer stem cells derived from placental tissue to babies in the womb to repair the defect that occurs when the protective tissue around a baby's developing spinal cord fails to fully close before birth. 2. e Steadman Philippon Research Insti- tute in Vail, Colo., received a grant from the National Institutes of Health in August to study the use of bone marrow stem cells to delay osteoarthritis in the knee. More than $2.8 million may be awarded to SPRI as part of NIH's Regenerative Medicine Innovation Project, which aims to accelerate clinical stem cell research. Enrollment for the clini- cal trials will begin this fall. 3. In August, biopharmaceutical company DiscGenics raised $50 million, which it is using to fund clinical trials of its alloge- neic, injectable disc cell therapy for lumbar degenerative disc disease. Discogenic Cells, biomedically engineered progenitor cells de- rived from human intervertebral disc tissue, are the active ingredient in IDCT. DiscGen- ics has secured more than $71 million in funding to date. 4. Most stem cell research is being con- ducted in animals, but many clinical trials have shown potential for spine surgery, according to Eeric Truumees, MD, president of the North American Spine Society. One interesting area "involves growing out cells on a scaffold and then surgically implanting the tissue into the spine," which could lead to shis in the management of spinal cord injury and intervertebral disc regeneration, he said. Many stem cell and regenerative medicine clinics have opened in the U.S., typically us- ing cells from the iliac crest or platelet-rich plasma, and oen as part of well-regarded spine practices, according to Dr. Truumees. While there are many testimonials about the efficacy of these products, the peer-reviewed evidence remains limited. Stem cell-based therapies may have a big future in ortho- pedics, but presently it's too soon to say, he said. 5. Stem cells in orthopedics and spine sur- gery are more hype than reality, according to Neel Anand, MD, professor of orthopedic surgery and director of spine trauma at the Cedars-Sinai Spine Center in Los Ange- les. Many patients seek out these highly marketed stem cell injections, which can cost thousands of dollars out of pocket, Dr. Anand said. In an interview with Becker's, he questioned the ethical side of providing these injections, which he considers experi- mental, rather than therapeutic. 6. e orthopedic industry is in the midst of a stem cell bubble, which could soon burst as researchers realize there's a lot more research that needs to be done, according to Adam Anz, MD, director of the Andrews Institute Regenerative Medicine Center in Gulf Breeze, Fla. Other products such as bone marrow aspirate and PRP have shown promise for the treatment of osteoarthritis. PRP has the largest body of work to "sup- port its use for osteoarthritis" but BMA and other products still have some work to do to prove their value, Dr. Anz said. n Mississippi spine surgeon operates on sand tiger shark's spine By Eric Oliver G autier, Miss.-based Bienville Orthopedics' Joseph Cox, MD, led a team of 12 specialists in perform- ing a spine surgery on Stella, a sand tiger shark, local news affiliate WMBF reported Nov. 16. Stella, a popular attraction at the Mississippi Aquarium, was struggling to swim. Veterinarian Alexa Delaune noticed a curvature to her spine, and further examination revealed Stella had a disruption in her spine. Standard treatments didn't alleviate the issue, so the veterinarian team had to think outside the box. "We thought let's do something that's never been done before," Dr. Delaune said to the media outlet. "Let's per- form spinal surgery on her." The team went to Dr. Cox, who agreed to operate on Stella. The procedure was unlike any other he planned for. "It's about as close to operating on an alien that you can get," Dr. Cox said to the media outlet. "Their physiol- ogy is way different from humans, so there were a lot of things that had to be taken into consideration." Stella also needed a custom-designed operating table that would allow her to be out of the water, but would keep her gills wet. After the two-hour operation, Stella seems to be recovering nicely. The aquarium hopes to return her to the Oceans Exhibit in a few weeks. n

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