Should Degenerated Intervertebral Discs of Patients with Modic Type 1 Changes Be Treated with Mesenchymal Stem Cells?

Herger, Nick; Bermudez-Lekerika, Paola; Farshad, Mazda; Albers, Christoph E.; Distler, Oliver; Gantenbein, Benjamin; Dudli, Stefan (2022). Should Degenerated Intervertebral Discs of Patients with Modic Type 1 Changes Be Treated with Mesenchymal Stem Cells? International journal of molecular sciences, 23(5) MDPI 10.3390/ijms23052721

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Low back pain (LBP) has been among the leading causes of disability for the past 30 years. This highlights the need for improvement in LBP management. Many clinical trials focus on developing treatments against degenerative disc disease (DDD). The multifactorial etiology of DDD and associated risk factors lead to a heterogeneous patient population. It comes as no surprise that the outcomes of clinical trials on intradiscal mesenchymal stem cell (MSC) injections for patients with DDD are inconsistent. Intradiscal MSC injections have demonstrated substantial pain relief and significant disability-related improvements, yet they have failed to regenerate the intervertebral disc (IVD). Increasing evidence suggests that the positive outcomes in clinical trials might be attributed to the immunomodulatory potential of MSCs rather than to their regenerative properties. Therefore, patient stratification for inflammatory DDD phenotypes may (i) better serve the mechanisms of action of MSCs and (ii) increase the treatment effect. Modic type 1 changes-pathologic inflammatory, fibrotic changes in the vertebral bone marrow-are frequently observed adjacent to degenerated IVDs in chronic LBP patients and represent a clinically distinct subpopulation of patients with DDD. This review discusses whether degenerated IVDs of patients with Modic type 1 changes should be treated with an intradiscal MSC injection.

Item Type:

Journal Article (Review Article)


04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Bermudez, Paola, Albers, Christoph E., Gantenbein, Benjamin


600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology








Pubmed Import

Date Deposited:

11 Mar 2022 11:19

Last Modified:

05 Dec 2022 16:14

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Modic change immunomodulation intervertebral disc mesenchymal stem cell regeneration stem cell therapy




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