Trabalho aceito para apresentação de pôster no World Spine II, Chicago, EUA. Agosto de 2003.

Autologous chondrocyte transplantation for intervertebral disc repair: a preliminary study.


Lombello CB1, Reis GM1, Silva M2, Pimenta LHM3
1 GMReis, Campinas / São Paulo, Brasil
2 University of São Paulo, São Paulo / São Paulo, Brasil
3 Hospital Santa Rita, São Paulo / São Paulo, Brasil

Purpose of the study
The difficulties in treating condral defects encouraged the development of autologous chondrocyte transplantation. The methods used to treat the intervertebral disc defects, such as protheses or fusion procedures, usually leads to a pain relief. The objective of cell therapy is to repair intervertebral disc tissue, achieving tissue constitution and biomechanics very similar to the preexisting normal tissue.

Methods used
We performed a pilot study with disc herniation at L5-S1 in four patients, three women and one man, age from 31 to 42. All these patients showed also disc degeneration in a lower grade at L4-L5. The objective of the study was to restore L4-L5 disc through autologous chondrocyte transplantation. The sequestretctomy of the excised nucleus pulpous resulted in disc tissue for cell culture. The culture was made by Biológica GMReis according to its technical procedures in order to achieve cellular proliferation. After approximately 4 weeks the cell suspension was injected in the adjacent intervertebral disc, L4-L5, through percutaneus postero-lateral puncture. The follow-up includes clinical evaluation of the patients for the immediate post-operative and the first two radiographic controls.

Summary of findings
The immediate post-operative showed symptoms relief, without image (MRI an RXs) adverse reaction to the cell suspension injection nor acute discopaty at the transplanted level. The radiographic control of the first two patients did not show until know any differences on the discs, including disc height and the degenerative aspects.

Relationship between findings and existing knowledge
The results achieved are consistent to what has been shown in different references of other groups, that show in a follow-up of six years. We are looking for an improve in the disc degeneration process with a recovery in disc height in one year.

Overall significance of findings
Based on this finds we are encouraged to extend the number patients in the pilot study and perform the complete follow-up protocol including: clinical examination, radioghraphy and NMR, at 1, 3, 6 and 12 months.