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Genomics, gene therapy have an exciting future in spinal care

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BOSTON — Personalized medicine in the spine surgery field is quickly approaching, according to a presenter here.

Nicholas Theodore, MD, presented data on the human genome, restoring function and regenerating areas of tissue destruction in the spine during a presentation at the Congress of Neurological Surgeons Annual Meeting.

Stem cell research during the past several years has made some interesting steps in the spinal field but remains largely undefined, according to Theodore.

“We do know that cells can migrate long distances on the spinal cord, and we’ll be able to hopefully exploit that in the treatment of the spinal cord,” he said.

Stem cells, and cells in general, like to be in contact with other cells, Theodore said. Scaffolding allows a cell to adhere to the structure and this applies, as well. He pointed to an example of a rat heart that was placed in detergent and decellularized. The heart was able to be repopulated with cells that adhered to the structure of the heart — a process that may be applicable to human organs in the future, according to Theodore.

“This is cutting-edge; this is state-of-the-art work. If we can do this with a heart, the question is, can we do this with a disc?” he said. “Ultimately, the heart was not only recellularized, but functioned. They were able to pump fluid into the heart, electrically stimulate it and the heart started to beat again.”

Theodore said his lab and many others are looking into taking a human spinal disc, decellularizing and repopulating the disc for the treatment of degenerative disc disease.

“Having the ability at some point, hopefully in our lifetime, to genetically engineer a disc will be a huge shift in the way we treat these patients,” he said.

Reference:

Theodore N. Balancing clinical research and individualized care: the era of “personalized medicine.” Presented at: Congress of Neurological Surgeons Annual Meeting; Oct. 18-22, 2014; Boston.

Disclosure: Theodore is a consultant for and receives royalties from Depuy Synthes Spine, Globus Medical and Stryker Spine.