1. Intervertebral Disk Degeneration
And Emerging Biologic Treatments
Journal of the American Academy of
Orthopedic Surgeons
Authors: Christopher K. Kepler, D. Greg Anderson, Chadi Tannoury and Ravi K. Ponnappan

2. Development and Delivery of Biologic
treatments for Intervertebral Disk
(IVD)Degeneration
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Tissue Re-implantation
Platelet-rich Plasma
Inflammatory Cytokine Upregulation
Gene Therapy

3. • Tissue Re-implantation – disk cells were
harvested at the time of a single-level
diskectomy for symptomatic herniated nucleus
pulposus. And re-implanted at 12 weeks after
primary procedure to allow healing.
• Platelet-rich Plasma – using stem cells to
differentiate into and repair the tissue in
question.

4. • Inflammatory Cytokine Upregulation – the
role of cytokines has been investigated in the
degenerative IVD but the biologic function of
these cytokines and their contribution to disk
degeneration are not well understood.
• Gene Therapy – adds the nucleic acid
sequence coding for the gene of interest along
with a promoter sequence
into the cellular genome.

5. Summation
It is unclear at what stage in the cascade of
degeneration therapies should be applied. Disks in
late-stage degeneration may lack regenerative
potential. Early-stage degeneration may be
asymptomatic and go untreated. Knowledge
regarding the complex environment of the disk is
growing rapidly and modern cell and molecular
biology are now capable of providing tools and
techniques to produce tissue repair.

6. The advancement of biologic treatments of common
diseases such as intervertebral disk degeneration has the
potential to be life changing for people suffering from such
ailments.
Currently patients dealing with the pain of IVD
have limited resources and often rely on medication in order
to perform daily functions. In the end, major spinal surgery
to implant titanium plates is needed for long term
relief, and is not always a guaranteed solution.

7. The advancement of biologic treatments of common
diseases such as intervertebral disk degeneration has the
potential to be life changing for people suffering from such
ailments.
Currently patients dealing with the pain of IVD
have limited resources and often rely on medication in order
to perform daily functions. In the end, major spinal surgery
to implant titanium plates is needed for long term
relief, and is not always a guaranteed solution.