This 12-month, open-label, nonrandomized prospective controlled trial evaluated the effectiveness and safety of a one-time injection of autologous bone marrow mesenchymal stem cells (BM-MSCs) targeted simultaneously into multiple spinal structures (discs, facets, spinal nerves, and sacroiliac joints) to address severe chronic low back pain from multi-structure lumbar degeneration. The study compared 40 patients receiving the stem cell intervention alongside conventional care against 40 control patients receiving conventional treatment. Conventional treatment included oral NSAIDs, physical therapy, and steroid injections (targeting the facet joints, SI joints, or epidural space).
At the 12-month follow-up, the BM-MSC group demonstrated statistically significant and clinically meaningful improvements over the control group; specifically, 67% of the stem cell patients achieved a minimal clinically important difference (MCID) in functional status compared to only 8% of the control group, and 56% maintained at least a 2-point reduction in pain. Additionally, the investigational group saw a significant reduction in opioid intake, while the control group showed a slight increase. Although limited by its single-center, nonrandomized design and a lack of correlation between clinical outcomes and post-procedure MRI changes, the study concludes that simultaneously treating multiple potential pain generators with autologous BM-MSCs is a safe and highly promising therapeutic option for severe spinal degeneration.
https://www.painphysicianjournal.com/current/pdf/NzQzMg3D3D/142
