Using innovation to combat degeneration…AAOS is announcing that a review article appearing in the June 2008 issue of the Journal of the American Academy of Orthopaedic Surgeons discusses how gene therapy may one day potentially offer some relief to millions of individuals who experience back pain due to disc degeneration.

In the news release, Mark Hubert, M.D., lead author of the article, stated, “Gene therapy involves taking a therapeutic gene and inserting it into the cells of a degenerating disc. This stimulates the cells to produce certain therapeutic proteins (such as growth factors and matrix proteins) that can help create an improved cushioning effect that is necessary in order to have a healthy disc.”

Dr. Hubert is part of a team of researchers headed by Dr. James Kang at the University of Pittsburgh School of Medicine. Dr Hubert indicates that while this type of therapy is in an experimental stage and is several years away from being available to patients, the hope is that it will eventually be able to help slow down and possibly reverse the process of painful disc degeneration. If successful, it may help patients suffering with this disorder to avoid surgery.

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Current treatments for symptomatic disc degeneration, for patients whose disc degeneration is symptomatic and already well established, can include but are not limited to:

  • Physical therapy
  • Nonsteroidal anti-inflammatory drugs
  • Epidural steroids
  • Surgery

Dr. Hubert says that gene therapy would be implemented at the earliest stages of disc disease to prevent the progressive degeneration of the disc. “We would hopefully prevent the problems associated with disc degeneration by attacking it earlier,” added Hubert.

There is currently no way to reverse the process of disc degeneration, Dr. Hubert explained in the news release, “Once it starts it is usually going to continue.”

Gene therapy is currently being tested in research studies and investigators indicate that in some of the animals the disc disease has shown significant improvement with slowing of the degenerative process. But human clinical trials are still years away and must await the full investigation of safety issues.