ABSTRACT
Promising new approaches for the biologic treatment of disc degeneration are evolving from a number of current scientific fronts, including: (i) an improved understanding of the function of the disc cell in vivo; (ii) advances in tissue engineering, (iii) advances in gene therapy techniques, and (iv) recognition of the potential value of stem cells in cell-based therapies. Biologic approaches to disc therapy are important as current methods of treatment, including fusion, disc spacers and disc replacement, are not physiologic, limit motion, and place excess stress on adjacent spinal segments. Methods which manipulate and modulate disc cell function open exciting and challenging new therapeutic possibilities. In this Chapter, we provide a current perspective on the progress relevant to biologic treatments for disc degeneration, as demonstrated by progress from basic science contributions toward the understanding of disc cell biology, manipulation of disc cells, and new biologic strategies for the therapy of intervertebral disc degeneration (Fig. 1).
