{"id":3666,"date":"2025-08-25T21:09:16","date_gmt":"2025-08-26T00:09:16","guid":{"rendered":"https:\/\/stemcelltherapyargentina.com\/the-decision-to-infiltrate-mesenchymal-cells-bmac-or-prp-in-the-intervertebral-disc-for-the-treatment-of-low-back-pain-an-option-with-significant-risks\/"},"modified":"2026-03-27T15:09:57","modified_gmt":"2026-03-27T18:09:57","slug":"the-decision-to-infiltrate-mesenchymal-cells-bmac-or-prp-in-the-intervertebral-disc-for-the-treatment-of-low-back-pain-an-option-with-significant-risks","status":"publish","type":"post","link":"https:\/\/stemcelltherapyargentina.com\/en\/the-decision-to-infiltrate-mesenchymal-cells-bmac-or-prp-in-the-intervertebral-disc-for-the-treatment-of-low-back-pain-an-option-with-significant-risks\/","title":{"rendered":"The decision to Infiltrate Mesenchymal Cells, BMAC or PRP in the Intervertebral Disc for the treatment of low back pain: An option with significant risks."},"content":{"rendered":"\n

Today we are going to explore a fascinating but controversial topic in the field of regenerative medicine: the infiltration of mesenchymal stem cells or platelet-rich plasma (PRP) directly into the intervertebral disc to treat discogenic low back pain. This approach is presented as a promising alternative to invasive surgery or conservative treatments, but it is not without risks.<\/strong> In particular, we will highlight the danger of discitis<\/strong> associated with the disc microbiome<\/strong>, which could lead to a negative evolution of the patient. Based on scientific evidence, we will analyze whether this is a viable option or whether safer approaches should be chosen. <\/p>\n\n

What Are Discogenic Low Back Pain and How Do These Therapies Work?<\/strong><\/p>\n\n

Low back pain, or lower back pain, affects millions of people worldwide and often originates from degeneration of the intervertebral discs. These discs act as shock absorbers between the vertebrae, but over time they can lose hydration, height and functionality, causing chronic pain. <\/p>\n\n

Regenerative therapies such as intradiscal injection of stem cells (usually mesenchymal stem cells derived from bone marrow or adipose tissue) or PRP seek to repair damaged tissue. PRP is obtained from the patient’s blood, concentrating platelets that release growth factors to promote regeneration. Stem cells, on the other hand, have the potential to differentiate into disc cells and reduce inflammation. Preliminary studies suggest that these injections may improve pain and function in patients with discogenic pain, with varying success rates in systematic reviews. <\/p>\n\n

Potential Benefits: An Innovative Solution?<\/strong><\/p>\n\n

These therapies are attractive because they are minimally invasive and rely on the body’s regenerative potential. For example, reviews indicate that stem cell or PRP injections can reduce discogenic low back pain in up to 50-70% of cases in the short term by promoting disc repair and modulating inflammation. In animal models and early clinical trials, an improvement in disc hydration and a decrease in degenerative markers have been observed. For patients who do not respond to physical therapy or medications, this represents an intermediate option before surgery is considered. <\/p>\n\n

However, not everything is positive. Although possible, these treatments are not always the best choice, especially when the inherent risks are considered. <\/p>\n\n

The Risks: The Role of the Disc Microbiome and the Risk of Discitis.<\/strong><\/p>\n\n

One of the main drawbacks is the risk of infection<\/strong>, specifically discitis (infectious inflammation of the disc), which can severely complicate recovery. The literature reports complication rates of about 1% in intradiscal orthobiologic injections, including severe infections. In documented cases, patients have developed discitis and osteomyelitis after stem cell injections, requiring prolonged antibiotics or even surgery. <\/p>\n\n

What makes this particularly risky? The intervertebral disc is not a sterile space as traditionally thought<\/strong>. Recent research reveals the existence of a complex intradiscal microbiome, with bacteria such as Cutibacterium acnes<\/em> (formerly Propionibacterium acnes<\/em>) present in degenerated or herniated discs. This microbiome may be in equilibrium under normal conditions, but the injection of biological substances rich in growth factors could alter this balance (dibiosis), promoting bacterial growth and leading to iatrogenic infections. <\/p>\n\n

Cutibacterium acnes<\/em> is the most common pathogen in these cases, as it colonizes the skin of the back and can contaminate during the procedure, or be activated from latent bacteria in the disc. In vitro studies show that leukocyte-poor PRP preparations allow increased growth of this bacterium, increasing the risk of discitis. In addition, the manipulation of stem cells (extraction and concentration) increases the chances of external contamination. <\/p>\n\n

As a result, patients may experience worsening pain from discitis, fever, stiffness and, in severe cases, permanent damage to the disc or adjacent vertebrae, leading to a “poor outcome” with the need for additional interventions.<\/p>\n\n

Risk mitigation strategies and final considerations<\/strong><\/p>\n\n

To reduce these dangers, strict protocols are recommended: use of leukocyte-rich PRP (with antimicrobial properties), prophylactic antibiotics such as cefazolin, double-needle techniques and extreme surgical sterility. Despite this, the risk persists, and reviews emphasize the need for more long-term studies and registries of complications. <\/p>\n\n

In conclusion, infiltrating stem cells or PRP into the disc is a possible option for refractory low back pain, but not necessarily<\/strong> the best due to the risk of discitis driven by the disc microbiome. Before opting for this, consult with specialists and consider alternatives such as physical therapy, epidural injections or minimally invasive surgery. Always prioritize treatments based on solid evidence and evaluate individual risks. <\/p>\n\n

Bibliography<\/strong>:<\/p>\n\n