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Spine Rapid Fire Abstract

Spine

Investigating the Impact of Stem Cell Treatment for Patients Undergoing Spine Fusion Surgery: A Systematic Literature Review and Meta-Analysis

Saturday, May 4, 2024
4:13 PM – 4:15 PM CT
Location:  S403ab
Disclosure(s):
Ishav Shukla, B.S.: No financial relationships to disclose
Michael Farid, BSE: No financial relationships to disclose
Sukul Mittal, BS: No financial relationships to disclose
Introduction: Spine fusion surgery is performed in patients who present with structural or neurological spine aberrancies. Traditional gold standard treatments result in a failed fusion or pseudoarthrosis rate as high as 35%. Stem cells, such as mesenchymal stem cells (MSC), are now being utilized to decrease the rate of pseudoarthrosis. In this literature review, we aim to synthesize existing literature investigating stem cell use in spine fusion, compare stem cell modalities, and analyze outcomes compared to standard-of-care (SOC) treatments.

Methods: A systematic review utilizing PRISMA guidelines was conducted across PubMed, SCOPUS, and Web of Science for studies discussing stem cell use in spine fusion.

Results: 23 studies including 1301 patients were analyzed. The mean age was 54.4 ± 10.2 years, and 45.4% were male. Bone marrow MSC were utilized in 856 patients (65.8%), cadaveric MSC in 432 patients (33.2%), adipose-derived MSC in 10 patients (0.77%), and umbilical cord-derived MSC in 3 patients (0.23%). When comparing stem cell modalities, risk difference analysis showed that cadaveric MSC, when compared to bone marrow MSC, had a significant decrease of 5.02% in the chance of having a successful fusion (p < 0.005). We then analyzed 10 studies comparing a stem cell cohort to a SOC cohort. 316 patients (53.2%) received SOC treatment while 278 patients (46.8%) received stem cell treatment. A random effects model showed that those who received stem cells had a 25% increase in their odds of having a successful fusion (OR 1.25, 95%CI 0.50-3.09), but this finding was not significant.

Conclusion : While stem cell utilization does not have statistical significance in improving fusion rate for patients undergoing spine fusion surgery in comparison to SOC treatment, comparing stem cell modalities yields significant differences in fusion rate. More studies are necessary to identify effective stem cell modalities that can decrease the rate of pseudoarthrosis and offer patients optimal recovery.