Stem cells

Over recent years there has been a huge amount of coverage in the press regarding ‘Stem Cells’. In mammals, there are two broad types of stem cells: embryonic stem cells and adult stem cells. These cells are present in the growing baby and have the capacity to develop into all the various tissue types that are required to generate a whole human body, bone, muscle, skin etc.

In adults, stem cells act as a repair system for the body, maintaining adult tissues in the normal turnover of regenerative organs, such as blood, skin, or intestinal tissues.

Stem cells can be taken from umbilical cord blood just after birth. In addition, there are three known accessible sources of adult stem cells in humans:

  1. Bone marrow, which requires extraction by harvesting, that is, drilling into bone (usually the long bone of the leg, or the pelvic brim).
  2. Blood taken from the donor, and passed through a machine that extracts the stem cells.
  3. Adipose tissue (fat cells), which requires extraction by liposuction.

These ‘autologous’ cells are obtained from one’s own body and can be stored in a similar way to the blood from those patients who have it taken and stored in a ‘blood bank’ should they be undergoing an operation that may need transfusion due to anticipated blood loss.

Adult stem cells are frequently used in medical therapies, for example in bone marrow transplantation. Stem cells can now be artificially grown and transformed into specialised cell types with characteristics consistent with cells of various tissues such as muscles or nerves.

Back pain and sciatica

Currently, stem cells are being used to treat a small number of patients for back pain where the shock absorbing discs of the lower spine may be damaged and inflamed. This causes pain. If the inflammation and damage involves the nerve passing alongside the damaged disc then leg pain or ‘sciatica’ can result.

The stem cells are taken or ‘harvested’ from bone, often the pelvic bone. The blood and cells taken from the bone marrow are then treated and the stem cells selected. The cells can then be injected around the damaged disc and nerves.

Some patients are gaining benefit from the technique, but there is little high quality data to confirm just how useful this treatment will prove to be. More studies are required to identify which patients are most suitable for this treatment and what the long term benefits may be.

Since the stem cells are taken from the patient’s own body, then the risk of problems are thought to be low, but naturally this needs to be monitored too. The procedure to harvest the cells and re-inject them into the problematic area is comparatively straight-forward and the risks are small, as these techniques are already well recognised and have been performed on numerous occasions.

Current situation

Stem cell treatment is an exciting concept and has many applications in medicine. The precise role in treating painful conditions, such as damaged discs in the spine is currently a long way from being clear. Over the coming years with the gathering of trial results and good data will hopefully open a new door to long term treatment.