Future advances for treating lumbar disc herniation and degeneration: Nucleus replacement, annular repair, and biologics

Intervertebral disc disease is a prevalent and costly clinical problem in the United States. Disease-modifying therapies applied at the early stages of disease are desirable compared to the traditional and variably effective surgical options for end-stage disease. A better understanding of the normal intervertebral disc and the molecular and cellular basis of disc degeneration has led researchers to investigate innovative therapies. Specifically the developments of biomaterial-based hydrogels and annular patches, cell implantation, growth factor modulation, and gene transduction techniques all hold clinical promise. The most powerful therapy may combine several of these modalities to achieve long-standing results.