Monash researchers show stem cells help back pain

Dr Idrees Sher

Neurosurgery research at Monash University focussing on stem cell regeneration to reduce back pain was recognised at the prestigious North American Spine Society annual meeting in Orlando, Florida last month.

Monash Health neurorsurgery registrars Dr Chris Daly (a Monash University PhD candidate) and Dr Idrees Sher (a Monash University Masters candidate) presented papers at the largest academic spine meeting and exhibition in the world.  Dr Sher won Best Science paper at the meeting.

Dr Idrees presented his research into mesenchymal precursor stem cells (MPCs) providing an alternative to surgery for disc degeneration and the management of discogenic lower back pain.  The study was published last month in the high impact The Spine Journal.

Research group leader at The Ritchie Centre (Monash University and the Hudson Institute of Medical Research) and Monash Health neurosurgeon Associate Professor Tony Goldschlager said the team is focusing on stem cell regeneration of the intervertebral disc.

“We have had success both in preclinical and clinical studies of being able to restore structure and function of the disc,” Associate Professor Goldschlager said.

“This reduces pain and improves quality of life for patients.”

“One challenge in our research has been detecting changes in the disc with MRI scans and Dr Sher’s award winning study has been able to study the disc using super high resolution (9.4T) MRI. This has produced some of the world’s first high quality images of the disc, with exquisite detail.”

In his study, Dr Sher used a number of investigation techniques including histology, mmunohistochemistry, polarised microscopy and MRI to demonstrate that MPCs provide a direct beneficial effect in the rate of repair and reconstitution in the degenerate and nutritionally compromised intervertebral discs during the first 4 weeks.

“We’ve shown MPCs provide an opportunity for earlier intervention and delay in the progression of disc degeneration,” Dr Sher said.

“Our findings provide novel insights in the actions of MPCs and support their use in degenerative disc disease, further paving the way for human trials.

Also at the annual scientific meeting in Orlando, colleague and Royal Australasian College of Surgeons Foundation for Surgery Richard Jepson Scholarship recipient Dr Daly presented his research into stem cells promoting disc healing following surgery.

“Lumbar discectomy is the most commonly performed spine surgery procedure worldwide and is very effective at relieving the symptoms of nerve compression, e.g. pain and weakness radiating down the leg, secondary to a slipped disc,” Dr Daly said.  

“However, the operation fails to reverse the underlying disc degeneration and as such, up to one third of patients will progress to suffer ongoing back pain and approximately one in seven will undergo further surgery.”

Dr Daly’s research demonstrated the ability of a type of adult stem cell from the bone marrow, when ‘primed’ by exposure to an arthritis medication, pentosan polysulfate, to promote regeneration of the intervertebral disc in preclinical models following discectomy surgery.  

“The treated disc appears healthier on MRI, biochemical, morphological and microscopic analysis then untreated discs following surgery,” Dr Daly said.  

“This study suggests the ability of these primed cells to promote disc healing following surgery in humans and will be investigated in a clinical trial in the near future.”

This research was carried out at the Monash Health Translation Precinct (MHTP), a collaboration of Monash University Departments of Surgery, Neurosurgery, Monash Imaging and Monash Biomedical imaging and the Hudson Institute.