What is an intervertebral disc cell transplant (disc renovation)?

With disc renewal (disc renovation - DR), we refer to a modern method that allows the replacement of worn tissue with vital own disc cells. Intervertebral disc cell transplantation (DR) helps to preserve the volume of the intervertebral discs and to restore their elasticity through biological renewal of the intervertebral disc tissue.

Discs are unique in their elasticity and buffering function. They have few cells, and when other organs have few living cells too, their healing process will also be limited. The tissue practically cannot recover on its own - as a result, the intervertebral disc can become thinner and flatter, and hardly buffer any strains. Cell transplantation can compensate this deficiency compensating the progressive degradation process of the intervertebral disc. Disc cells, which grow very slowly in the human body, can grow rapidly in the laboratory and multiply thousands of times. The body easily accepts the cells grown in the laboratory because they do not differ in their structure and effect from the body's own cells.

When is the transplantation of an intervertebral disc necessary?

The medical term indication (from Latin indicare "indicate", synonymously also cure indication) indicates why a treatment measure is appropriate. The term is often associated with surgery; one then speaks of operation indication. In case of herniated disc, lumbar spine or cervical spine protrusion, or disc degeneration or after surgery on a herniated disc (microsurgery), intervertebral disc cell transplantation could be a useful method.

Operation course - the implantation of an intervertebral disc takes place in three steps

  1. Removal of disc material: The recovery of disc material or tissue is made through percutaneous procedure (percutaneous nucleotomy) or by microsurgery. As a rule, these procedures are planned anyway in order to achieve a decompression of the neural structures. In percutaneous nucleotomy, after local anesthesia, a special cannula is inserted under fluoroscopy into the affected lumbar intervertebral disc segment. This procedure is performed on the cervical spine under general anesthesia. A special micro forceps or spiral is then inserted through the cannula to remove intervertebral disc material. The microsurgery is done under general anesthesia via a small skin incision and with the help of a microscope the affected area is reached and the hernia is removed. This will decrease the pressure in order to give more space to the nerve roots. The tear of the fiber ring will be closed and to avoid adhesions, around the neural structures will be injected an anti-scar gel.
     
  2. Cell proliferation in the laboratory: In a special laboratory, experts isolate healthy cells from the extracted tissue with the highest hygienic safety standards. The cells are filled into a container and cultivated with serum from the patient without the addition of hormones. Under certain conditions (temperature, humidity, pressure, oxygenation) the cells multiply millions of times inside an incubator. This process usually takes 4 weeks.
     
  3. Implantation of the obtained cells: The implantation of the cells obtained in the laboratory takes place at the earliest in 4 weeks after the first intervention in the affected disc. Under local anesthesia, and with fluoroscopy control, a very fine cannula is inserted into the middle of the affected disc. Through this cannula, the cells are injected. This procedure takes a few minutes. After only a few weeks-months, the cells regain their natural shock absorber function. As a result, the elasticity of the intervertebral disc increases, and its height is usually maintained. The risk of new herniated discs is thereby reduced. Since we only multiply endogenous cells. Usually no allergic rejection reactions occur.

On the day of the operation

The implantation of the cells takes place under 4-5 days stationary conditions. On the day of the procedure patients must lie down. They will receive mild physiotherapy and medicines (even if rarely) equally mild. 

The next days after the operation

The day after the intervertebral disc implantations is the day in which you will be mobilized with a specific physiotherapeutic program. At the same time bending, twisting and sitting must be avoided.

After discharge, you should rest for about 10 days, after which you can start with physiotherapy. You can resume your private and professional activities in just 2 weeks. You can swim 10 days after discharge, cycling in 2 weeks, driving in 10 days, fitness 3-4 weeks, golf 6-7 weeks, tennis 7-8 weeks, skiing 8-9 weeks. Fly 2 weeks. Three months after the operation a MRI should be made in order to check the improvements.

Pros and cons of disc cell transplantation

Intervertebral disc cell transplantation is an investment for your future: You will literally feel the benefits: the back pain will probably go away, you will ideally painless, and the regained back mobility will make you happy. In fact, the rate of complications from the disc cell transplantation itself is very low. There may be complications like bleeding or inflammation within the spinal canal, but these are real exceptions. In order to reduce the risk of hitting a nerve, your well-trained specialist will be extremely careful while inserting needle.

Dr. med. Munther Sabarini

Author
Dr. med. Munther Sabarini
Specialist in Neurosurgery

Hans-Heinrich Reichelt

Co-author
Hans-Heinrich Reichelt
Chief Editor of Medizin für Menschen

The Avicenna Clinic in Berlin is always willing to help you

Since the year 2001, the Avicenna Clinic is based in Berlin. Our doctors have at least 25 years of international experience in their respective fields (neurosurgery, spinal surgery, anesthesia, and orthopedics).

If you have severe back pain, a herniated disc or a suspected herniation, please contact us using the following information:

Avicenna Clinic
Paulsborner Str. 2
10709 Berlin

Telephone: +49 30 236 08 30
Fax: +49 30 236 08 33 11
E-Mail: info@avicenna-klinik.de

You can call anytime, write an e-mail or fill out a callback form. Each patient then gets an appointment with a doctor of our clinic, who is a spine specialist (neurosurgeon). Based on MRI images (brought or made in our clinic) and on an in-depth examination, the doctor will discuss with you all the different therapy options or possibly surgery. You can also use our specialists only to obtain a (second) opinion.

If you decide to undertake your therapy and/or surgery in Berlin, we would want to make your stay as pleasant as possible. In our clinic, you are at the center of our attention! You can expect state-of-the-art equipment in all areas - from the operating room to the patient bedroom.

The latest, gentle, minimally invasive treatment procedures are the focus of our clinic. Together we try to find a suitable treatment for your complaints. The actual therapy takes place only after a detailed discussion with the patient, examinations and the diagnostics.

For us, as important as medical care, it is the commitment we take to guarantee our patients a high level of personal care that can, in turn, ensure them a comfortable stay.

During the period of inpatient stay our team of nurses will take care of you 24 hours a day. They also offer services in several foreign languages, including English, Russian, Polish, Turkish, Spanish, Italian, Arabic, Bulgarian and French. We care not only about your safety but also your needs, respecting traditions and religions.

Our team is made up of a group of highly qualified specialists who work together to guarantee you a quick recovery.