Vertebral body defects treated with umbilical-cord mesenchymal stem cells combined with hydroxyapatite scaffolds: The first case report

Abstract

Introduction: Vertebral body defects (VBDs) are one of the most frequent orthopaedic disorders. Such defects often require bone grafts or fusion procedures; however, both procedures often fail due to various factors. Mesenchymal stem cells (MSCs) have been used as a potential therapy to fill bone voids in bone defects, and they may be a potential treatment for VBDs. We reported VBDs treated with MSCs combined with hydroxyapatite scaffolds.

Presentation of case: A 27-year-old female presented with recurrent back pain. She had a history of decompression and stabilization procedure one year ago after diagnosed with spinal tuberculosis. Initially, she felt back pain that intensifies with activity and relieved with rest. She noticed that the pain begun when once she heard a crack sound on her back while trying to get up from sitting position. There was no history of numbness or tingling sensation. There were no walking problems. Other functions, including micturition and defecation, were within normal limits. The patient firstly underwent lumbotomy procedure, and the images were all confirmed with fluoroscopy X-ray. The vertebrae went debridement, and finally, the bone defect was filled with 20 millions of umbilical cord-mesenchymal stem cells (UC-MSCs) combined with hydroxyapatite in 2 cc of saline.

Discussion: At three months postoperative, the patient could walk and had no pain. At six months of follow-up, no complications occurred. We also did not see any signs of neoplasm formation, which is consistent with previous studies that used MSCs for orthopaedic treatment. Moreover, no significant bone deformation or spinal cord compression was observed, which suggested the safety of the transplantation procedure.

Conclusions: We found that MSCs combined with hydroxyapatite represents a potential therapy for bone regeneration in VBD. Further clinical studies are required to investigate the safety and efficacy of this combination of therapy in VBDs.

Keywords: Hydroxyapatite; Mesenchymal stem cells; Vertebral body defects.

Fig. 1

Clinical picture shows scar on thoracolumbar area.

Fig. 2

Broken of bilateral rod.

Fig. 3

Lumbotomy procedure on left side. It shows the vertebral body defect at thoracolumbar area.

Fig. 4

Procedure of putting hydroxy apatite with stem cell on vertebral body defect.

Fig. 5

(a) This picture shows intact implant on posterior and defect big vertebral defect at level L1 L2; (b) Bone subtitutes with mesenchymal stem cell are on the defect of vertebral body. They fulfilled the defect on good position.