Stem cell therapy for intervertebral disc degeneration: Clinical progress with exosomes and gene vectors

Table 4 Comparison of stem cell therapy and traditional treatments

Treatment method	Advantages	Indications	Limitations	Clinical application cases
Conservative treatment	High safety, suitable for early-stage patients, usually includes medication and physical therapy, low risk	Suitable for patients with early mild symptoms	Cannot reverse disc degeneration, limited effectiveness, can only temporarily relieve symptoms	Commonly used for early IVDD patients but cannot fundamentally stop disease progression
Minimally invasive surgery	Minimal surgical trauma, shorter recovery time, low risk	Applicable to patients with moderate IVDD	The effect may not be as good as traditional surgery, and symptoms may recur in some patients	Shows good short-term effects in some patients, suitable for those unwilling to undergo invasive surgery
Open surgery	Relieves nerve compression symptoms caused by disc herniation; spinal fusion can restore spinal stability	Suitable for severe degenerative disc disease and neurological symptoms	High trauma, long recovery time, high surgical risks, possible postoperative complications, and inability to restore normal disc function	Surgical treatment can effectively relieve pain and neurological symptoms, but recovery is slow, and there is a risk of recurrence
Stem cell therapy	Minimally invasive, with regenerative potential, capable of repairing disc tissue through differentiation and paracrine mechanisms; has immunomodulatory effects, reduces inflammation, and inhibits apoptosis	Applicable to early IVDD patients who do not respond to traditional treatments	The long-term survival rate and safety of stem cells in the disc require further research, with potential risks of immune rejection and tumor formation	Clinical trials indicate that BMSC injections can significantly reduce patient pain, with follow-up showing increased hydration of the nucleus pulposus
Stem cell + exosome therapy	Stem cell exosomes help enhance stem cell survival rate, and exosomes act as carriers of signaling molecules, promoting tissue repair	Suitable for patients who are not candidates for surgery	Long-term efficacy needs further validation, and the isolation and preparation techniques for exosomes still need improvement	Combining gene editing technology and biomaterials has enhanced its regenerative effects, with preclinical studies demonstrating significant regenerative potential

IVDD: Intervertebral disc degeneration; BMSCs: Bone marrow-derived mesenchymal stem cells.