A new minimally invasive treatment for degenerated spinal discs has shown impressive results in clinical trials, significantly reducing back pain severity and improving function in patients with chronic discogenic pain. The treatment could potentially delay or eliminate the need for surgical intervention.
Promising Results for Nucleus Pulposus Allograft
The clinical trial, conducted by VIVEX Biologics, evaluated VIA Disc NP, a non-surgical treatment that supplements degenerated disc tissue with donated nucleus pulposus (NP) material. The NP is the gel-like core of intervertebral discs that acts as a shock absorber and pressure distributor in the spine. With age or injury, the NP degenerates, leading to chronic discogenic back pain.
Twenty-eight participants with an average age of 44 were enrolled in the study. All had suffered from lumbar discogenic pain for six or more months that had not responded to conservative management approaches, including oral analgesics, physical therapy, chiropractic care, and epidural steroid injections.
"The ability to effectively manage chronic lumbar discogenic pain in this patient group for a one-year duration with a single intradiscal NP procedure translated to correspondingly durable improvements in back function," the researchers reported.
Treatment Process and Patient Experience
The VIA Disc NP treatment uses human nucleus pulposus obtained from donated disc tissue of deceased persons. The tissue is morselized (chopped into small fragments) and sterilized before being reconstituted with sterile saline and injected into the patient's degenerated intervertebral disc.
The procedure is performed while patients are awake but sedated, with local anesthesia at the injection site. Notably, patients can return home the same day and resume normal activities the following day, making it significantly less disruptive than surgical alternatives.
Significant Pain Reduction and Functional Improvement
Study participants reported a statistically significant decrease in pain scores from 7.1 points at baseline to 3.8 points at 12 months on an 11-point numeric rating scale. Almost 60% of participants reported a 12-month back pain severity score of three or less.
Functional improvements were equally impressive. Scores on the Oswestry Disability Index (ODI), a widely accepted tool for assessing low back pain disability, fell from 53 at baseline to 24 at 12 months. Before treatment, 82% of participants had ODI scores placing them in the "severe" or "crippled" disability categories. By the 12-month follow-up, this number had dropped to just 18%.
"We noted no further degradation in treatment efficacy between six and 12 months," the researchers stated, referring to their earlier pilot study findings.
Safety Profile and Study Limitations
The treatment demonstrated a generally favorable safety profile. Mild-to-moderate adverse events, including low back pain, back muscle spasms, and thigh pain, were reported but resolved without intervention. There was one serious adverse event—injection site inflammation—that was definitely related to the procedure but subsequently resolved. No secondary surgical interventions were required for any participants.
The study does have limitations, including its small sample size, the lack of a control or placebo group, and the loss of some participants before the 12-month follow-up. However, the researchers emphasized the importance of their findings for the future of back pain treatment.
Alternative Approaches: Targeting "Zombie Cells"
In related research, scientists at McGill University have discovered another promising approach to treating chronic low back pain by targeting senescent "zombie cells" that accumulate in spinal discs with age or injury. These cells secrete inflammatory factors that exacerbate pain and accelerate disc degeneration.
The McGill team found that two drugs—RG-7112, an FDA-approved cancer drug, and o-Vanillin, a natural compound derived from turmeric—can clear these harmful cells from spinal discs. When combined and administered orally to mice with degenerated spinal discs, the treatment reduced inflammation and pain while showing clear signs of disc recovery after eight weeks.
"We were surprised that an oral treatment could reach the spinal discs, which are hard to access and present a major hurdle in treating back pain," said Professor Lisbet Haglund, who led the research.
Future Implications
Both approaches represent significant advancements in the treatment of chronic back pain, potentially offering alternatives to current symptom-focused treatments like painkillers, anti-inflammatory medications, and invasive surgery.
"Lengthening the duration of treatment efficacy has important implications for the potential of intradiscal NP treatment in delaying more invasive surgical options such as disc arthroplasty or instrumented spine fusion," noted the VIVEX researchers.
As these treatments progress through further clinical evaluation, they could transform the management of degenerative disc disease, providing lasting relief for millions of people worldwide who suffer from chronic back pain.
