Disc-related Back Pain

Shared pain, shared knowledge: driving innovation in spine research

Are you suffering from lower back pain? You are not alone - low back pain is a major cause of disability worldwide. A key factor contributing to this pain is the degeneration of the discs in your spine, accounting for about 40% of all cases. In many of these cases this pain will pass, but unfortunately in 5% of those, accounting for an estimate of 40 million  sufferers, it will result in chronic lower back pain due to disc degeneration. Unfortunately, current regenerative approaches fail to achieve tissue regeneration and only relief pain temporarily.

Did you know that dogs too suffer from the consequences of low back pain? Large-breed and working dogs [police, military dogs] are overrepresented with low back pain. Disc-related low back pain forces both humans and working dogs into early retirement!

At Utrecht University, we collaborate with a multi-disciplinary network, involving academia and industry, to advance innovative therapies that will outperform current regenerative therapies in the clinic and achieve enduring low back pain reduction in veterinary and human patients.

Nature-inspired therapies bring together stem cells and biomaterials for disc regeneration

Utrecht University coordinated the iPSpine project - a groundbreaking initiative with the long term aim of finding a solution for moderate disc-related low back pain. Our goal is to develop a new therapy using induced pluripotent stem cells (iPSC), reprogrammed stem cells that can be turned into different cell types for therapeutic purposes. Thus far, we achieved turning the reprogrammed stem cells into juvenile disc cells and tested two safe biomaterials that protect and nourish these juvenile disc cells. We have confirmed that the cells survive in degenerated discs, which is a crucial step in initiating disc regeneration. Ongoing work focuses on better understanding how the tissue environment contributes to the differentiation capacity of the iPS cells to regenerative disc cells, allowing for the development of effective cell therapy.

iPSpine: Induced pluripotent stem cell-based therapy for spinal regeneration

Strengthening the disc’s own repair mechanisms without using cells

Back pain due to intervertebral disc deterioration is a chronic disease that significantly affects daily life. The embryonic development of intervertebral discs is directed by a “blueprint” consisting of a package of important signal molecules. We use these powerful signals to rejuvenate the deteriorated discs and incorporate them into advanced synthetic nanovesicles. A specialised biomaterial will accommodate the nanomedicine, providing disc cells with a natural environment to thrive once they have taken up the rejuvenating instructions. Hereby, the project sets out a course to develop an injectable nanomedicine that can initiate disc regeneration and achieve enduring pain relief. In parallel, in a collaborative effort, we pursuit gene therapy as a potential therapeutic approach suitable for local delivery to the disc with long lasting expression of the desired therapeutic proteins by the resident disc cells, stimulating disc repair.

Inspired by nature, we use powerful biological signals to rejuvenate degenerated disc cells and initiate disc regeneration

Rejuvenation treatment for worn-out intervertebral discs – Vici research by Marianna Tryfonidou

More natural disc implants

We designed artificial discs to replace damaged or degenerated intervertebral discs while preserving the physiological motion at the treated spine. Although first generation artificial discs are mobile, they do not fully facilitate physiological motion. Therefore, in collaboration with TU Eindhoven we developed a biomimetic artificial intervertebral disc (bioAID) with biomechanical properties aimed to be more like the healthy disc. Biomechanical analysis demonstrates that the bioAID mimics the biomechanical behaviour of a natural disc. Current work focuses on further improving surgical placement of the implant and generate evidence that bioAID becomes firmly anchored to the bone. This is one of the essential steps for the long term stability and function of the biomimetic artificial disc.

Our team members