Facing page: Alice Begley This page: Mr Tony Goldschlager and Ms Alice Begley
Fast facts In this world-first phase 2 clinical trial stem cells are used to encourage bone fusion between remaining discs following major surgery. About 10--15% of the population will be experiencing neck pain at any one time. 1 Less than one in 100 cases of neck pain are caused by a serious medical problem. 2 A slipped disc in the neck can caused pain in the arm or spinal cord compression which may require surgery. 3 1:
‘Acute Neck Pain’, National Health and Medical Research Council, Information Sheet No. 3 (February 2004) available at www.nhmrc.gov.au
2:
‘Neck Pain’, Arthritis Australia, Information Sheet (2007) available at www.arthritisvic.org.au
3:
Goldschlager T, Jenkin G, Ghosh, P, Zannetinno A and Rosenfeld JV, ‘Potential applications for using stem cells in spine surgery’, Current stem cell research and therapy, 2010 (5): 345-355
In 2011, Consultant Neurosurgeon, Mr Tony Goldschlager, and his team conducted a world-first phase 2 clinical trial in 12 patients suffering from severe neck pain at Monash Medical Centre Clayton. The trial involved the use of stem cells in a novel way and was sponsored by an Australian company, Mesoblast. The trial offers hope to sufferers of cervical spine degenerative disease (slipped disc), where the discs that lie between the vertebrae in the neck degenerate over years of wear and tear. It is reported that by the age of 60, most people have some form of degenerative disc disease, but not everyone has obvious symptoms. The usual procedure for a slipped disc involves major surgery to remove the disc and then insertion of a small cage in-between the remaining discs to allow bone fusion to occur. For some patients, fusion does not occur and their pain remains. Such patients were recruited for the trial and the standard operation for slipped discs was conducted. Some patients were randomised to receive an additional injection of adult stem cells into the cage to encourage fusion between the remaining discs. This was a blinded trial, meaning neither the patients nor their assessors were informed as to whether they received stem cells or not. Stem cells offer a unique treatment option as there is no evidence of rejection and the cells have the ability to turn into bone or to secrete factors which stimulate the body to make bone. Stem cells have known anti-inflammatory properties which can assist in the reduction of pain. To date, the stem cells have been safe and well tolerated without any adverse events. This is very exciting as previous therapies (such as bone morphogenetic proteins) have not been safe when used in the cervical spine. Tony plans to continue his stem cell research with an additional trial targeting back pain which is scheduled to begin in 2012. Tony will also spend time in 2012 completing a Clinical Fellowship in Vancouver, Canada.
Southern Health Research Report 2011
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