Effects of the intradiscal implantation of stromal vascular fraction plus platelet rich plasma in patients with degenerative disc disease

Abstract

Background: Stromal vascular fraction (SVF) can easily be obtained from a mini-lipoaspirate procedure of fat tissue and platelet rich plasma (PRP) can be obtained from peripheral blood. The SVF contains a mixture of cells including ADSCs and growth factors and has been depleted of the adipocyte (fat cell) population. We evaluated the safety and efficacy of administering SVF and PRP intra-discally into patients with degenerative disc disease.

Methods: A total of 15 patients underwent a local tumescent liposuction procedure to remove approximately 60 ml of fat tissue. The fat was separated to isolate the SVF and the cells were delivered into the disc nucleus of patients with degenerative disc disease. The subjects were then monitored for adverse events, range of motion, visual analog scale (VAS), present pain intensity (PPI), Oswestry Disability Index (ODI), Beck Depression Inventory (BDI), Dallas Pain Questionnaire and Short Form (SF)-12 scores over a period of 6 months. Safety events were followed for 12 months.

Results: No severe adverse events (SAEs) were reported during a 12 month follow up period with no incidences of infection. Patients demonstrated statistically significant improvements in several parameters including flexion, pain ratings, VAS, PPI, and short form questionnaires. In addition, both ODI and BDI data was trending positive and a majority of patients reported improvements in their Dallas Pain Questionnaire scores.

Conclusions: Overall, patients were pleased with the treatment results. More importantly, the procedure demonstrated a strong safety profile with no severe adverse events or complications linked to the therapy. Trial registration NCT02097862. Name of registry: www.clinicaltrials.gov . https://ichgcp.net/clinical-trials-registry/NCT02097862?term=bioheart&rank=6 . Date of registration: March 25, 2014; Date of enrollment: March 2014.

Keywords: Adipose derived stromal/stem cells (ADSCs); Adipose tissue; Back pain; Cell therapy; Degenerative disc disease; Platelet rich plasma (PRP); Stem cells; Stromal vascular fraction (SVF).

Figures

Fig. 1

a Adipogenesis fat differentiation (Oil Red-O), b osteogenesis bone differentiation (Alizarin Red S), c chondrogenic cartilage differentiation (toluidine blue sodium borate stain)

Fig. 2

a Average flexion, b average change in flexion

Fig. 3

a Average pain ratings, b average change in pain ratings

Fig. 4

a Average visual analog score and present pain index, b Average change in VAS and PPI

Fig. 5

a Average oswestry disability index, b average beck depression inventory, c average change in ODI and BDI

Fig. 6

a Average dallas pain questionnaire results, b percentage of patients with improvements in dallas pain questionnaire

Fig. 7

a Average short form questionnaire results, b average change in short form questionnaire