Abstract:
Orthoregeneration is defined as a solution for orthopaedic conditions that harnesses the benefits of biology to improve healing, reduce pain, improve function, and, optimally, provide an environment for tissue regeneration. Options include drugs, surgical intervention, scaffolds, biologics as a product of cells, and physical and electromagnetic stimuli. The goal of regenerative medicine is to enhance the healing of tissue after musculoskeletal injuries as both isolated treatment and adjunct to surgical management, using novel therapies to improve recovery and outcomes. Various orthopaedic biologics (orthobiologics) have been investigated for the treatment of pathology involving the spine, including lower back pain, with or without numbness and/or dysfunction in the lower extremities, disc herniation, spinal stenosis, and spondylolisthesis. Promising and established treatment modalities include repair of the annulus fibrosis, injection of expanded or nonexpanded autologous or allogenic cells that are chondrogenic or from a stem cell lineage used to promote matrix tissue regeneration of the intervertebral disc, including nucleus pulpous cells and mesenchymal stem cells isolated from bone marrow, umbilical cord blood, or adipose tissue; and injection of platelet-rich plasma, platelet-rich fibrin, or fibrin sealant. Early clinical studies show promise for pain reduction and functional recovery. LEVEL OF EVIDENCE: Level V, expert opinion.
摘要:
矫形术被定义为骨科疾病的解决方案,利用生物学的好处来改善愈合,减轻疼痛,改善功能,和最佳的,为组织再生提供环境。选项包括:药物,手术干预,脚手架,生物制品作为细胞的产物,物理和电磁刺激。再生医学的目标是增强肌肉骨骼损伤后组织的愈合,作为隔离治疗和手术治疗的辅助手段。使用新疗法来改善恢复和结果。已经研究了各种骨科生物制剂(直视生物学)用于治疗涉及脊柱的病理学,包括下背部疼痛,有或没有下肢麻木和/或功能障碍,椎间盘突出,椎管狭窄,和脊椎前移.有希望和确定的治疗方式包括修复纤维环;注射成软骨的或来自干细胞系的扩增或非扩增的自体或同种异体细胞,用于促进椎间盘的基质组织再生(IVD)。包括从骨髓中分离的髓核细胞和间充质干细胞,脐带血,或脂肪组织;并注射富含血小板的血浆,富血小板纤维蛋白,或纤维蛋白密封剂。早期临床研究显示疼痛减轻和功能恢复的希望。V级,专家意见。