Low back pain (LBP) remains a leading contributor to global health loss, with its disease burden escalating steadily worldwide. Intervertebral disc degeneration (IDD) serves as the primary pathological basis for specific forms of LBP, driven by a multifactorial cascade involving molecular, biochemical and structural alterations. Conventional conservative treatments merely mitigate symptoms without abrogating or reversing the degenerative process, while surgical interventions—though effective for relieving neural compression—fail to regenerate damaged disc tissue and carry inherent risks such as recurrence. In this context, cell-based therapies have emerged as a major focus of regenerative research for IDD, offering unique potential to facilitate tissue repair and ameliorate pain. Nevertheless, substantial hurdles endure: the mechanisms of action remain incompletely defined, standardized cell products are lacking, and robust evidence supporting long-term safety and efficacy is scarce. This review focuses on cell-based therapies for IDD, systematically examines the global research landscape and recent advances, investigates the proposed mechanisms of action, analyzes the current status of clinical research, and outlines future directions, aiming to inform and guide further exploration in this rapidly evolving field.The Translational Potential of this Article: This work systematically synthesizes current research landscape of cell-based therapies for IDD, elucidates key translational hurdles, and proposes actionable solutions, delivering critical guidance to accelerate the translation of cell-based therapies into clinical practice.

Background Symptomatic pseudomeningocele (PMC) causing spinal cord compression is a severe complication following spinal surgery. Traditional management remains controversial, with surgical revision carrying significant risks. This study evaluates an innovative minimally invasive approach using central venous catheterization for percutaneous PMC drainage.Case Presentation A multicenter case series included 17 patients with thoracic ossifying disease who developed PMC with neurological deterioration postoperatively. Under B-ultrasound guidance, an experienced spinal surgeon performed percutaneous puncture and drainage of the PMC using a central venous catheter system. All patients achieved complete PMC drainage confirmed by MRI, with resolution of spinal cord compression.Conclusion Ultrasound-guided central venous catheter drainage is a safe, effective, and minimally invasive alternative for managing PMC-induced spinal cord compression. This technique achieves rapid symptomatic relief, neurological recovery, and durable results without recurrence. Its successful extension to postoperative pseudocyst/abscess drainage suggests broad applicability in spinal complications.

Background: Low back pain (LBP) is the leading cause of disability among the elderly, placing significant social and economic burdens on societies globally. A common cause of chronic LBP is lumbar disc degeneration. Previously, we reported that autologous or allogenic fibroblast injections could treat intervertebral disc degeneration (IVDD) in preclinical studies by maintaining disc height and stability through fibrosis. However, the pathway to successful drug development remains unclear. Methods: To develop a novel human allogenic fibroblast injection, we launched a quality-by-design (QbD) project focusing on human dermal fibroblasts (HDFs). Results: We developed a tissue separation process, HDF culture process, and HDF cryopreservation process. The tissue disinfection method used 5% povidone-iodine solution and 75% alcohol for 3–5 min each; the tissue digestion conditions used neutral protease AF followed by overnight soaking plus collagenase NB6 digestion for 2–3 h; the non-animal component medium contained high glucose dulbecco’s modified eagle medium (DMEM) + 7.5% human platelet lysate (hPL); A cell density of 14,000–18,000 cells/cm2 was used; the cell cryopreservation solution contained 75% CS10 + 10% human serum albumin (HSA) + 15% saline (NaCl). Finally, we explored its therapeutic effects by treating IVDD in rabbits. Conclusions: The model of lumbar disc degeneration in rabbits was induced by acupuncture, and HDF was injected into the intervertebral disc. The therapeutic effect of HDF was observed by imaging and histopathology at 1, 3, and 6 months after administration. HDF treatment significantly improved the water content of degenerative intervertebral discs and maintained the height and stability of intervertebral discs. Signal pathway analysis in cynomolgus monkeys suggested that the primary mechanism involves promoting disc fibrosis. Therefore, this study demonstrated the feasibility and cost-effectiveness of manufacturing FibroCellTM, a foreskin-derived human dermal fibroblast injection. FibroCellTM shows promise as a cell-based therapy for IVDD treatment.

OBJECTIVE:This study aimed to investigate the effects of lumbar interbody fusion-induced biomechanical changes on the adjacent segments, especially disc height and segmental lordosis restoration, and to provide more information for proper surgical strategy selection. METHODS:The medical records of 528 patients who underwent posterior lumbar interbody fusion were retrospectively reviewed, and a total of 89 patients were included. Surgical indications included degenerative spondylolisthesis (nonspondylolytic), marked disc herniation, or lumbar spinal stenosis requiring extensive decompression at L4/5. Postoperative adjacent segment degeneration (ASD) was assessed based on X-rays and functional status. Disc height, foraminal height, segmental lordosis, lumbar lordosis, and cage geometry were compared between the ASD and non-ASD patients. To identify the possible risk factors for radiographic ASD, univariate analysis was performed first, followed by multivariate logistic regression using variables with P < 0.20. RESULTS:Univariate analysis revealed that the postoperative disc height in the non-ASD group were significantly greater than in the ASD group. The postoperative segmental lordosis in the non-ASD group was significantly greater than that in the ASD group, and the lumbar lordosis in the non-ASD group was also significantly greater than that in the ASD group at the final follow-up visit. Four variables were identified as independent risk factors for ASD by subsequent multivariate logistic regression: postoperative relative disc height of L4/5 (P = 0.011), postoperative segmental lordosis (P = 0.046), lumbar lordosis at the final follow-up visit (P = 0.007), and cage height (P = 0.038). CONCLUSIONS:Improved lumbar lordosis is correlated with a lower incidence of ASD, and adequate disc height and segmental lordosis restoration are essential for ASD prevention.