Disc regeneration: A glimpse of the novel interventional approaches

The normal intervertebral disc clinically acts to support and dissipate loads while permitting multiaxial motionsof the spine. Its demanding mechanical function is provided by a well-defined microstructural organization andbiochemical composition. Intervertebral disc degeneration is a complex process that disrupts this well-definedorganization and biochemical balance. One hallmark of intervertebral disc degeneration is the loss ofproteoglycan and water in the Nucleous Palposous. Because of the central role of proteoglycans in thefunction of the intervertebral disc, restoration of normal proteoglycan production may be critical. Many differentbiological and interventional strategies have been developed, including the use of cells, scaffolds, andmolecules. The molecules used to treat disc degeneration include anticatabolics such as anti IL-۱, TNF agentsand growth factors or its stimulants, which may influence the cell proliferation rate and phenotypic expressionof the cells. Delivery of the molecules may include direct injection into the disc and also in vivo and ex vivogene therapy using a viral vector. Autologous or allograft reinsertion, injection and transplantation of NucleousPalposous cells, and stem cells therapy are methods of use of cells for disc regeneration. The purpose of acellular scaffold is to provide an optimal environment for cellular migration and proliferation that allowsmaintaining the appropriate phenotype. Collagen is a physiological biomolecular scaffold and hyaluronan actsas an anchor for aggrecan retention by promoting proteoglycan aggregate formation.