fibrin and Low-Back-Pain

Low back pain and subsequent disabilities are common. A lumbar spinal fusion procedure is an effective treatment with autologous bone grafts, but harvesting the bone from the iliac crest is associated with risks of complications. New treatments using stem cells together with osteoconductive and otesoinductive materials have made the procedure safer, but the inconsistency of the amount of stem cells harvested from bone marrow aspirate still remains to be solved. This study reports that the bone dusts, usually discarded as surgical wastes during transforaminal lumbar interbody fusion procedure (TLIF procedure), yielded cells which had the characteristics of mesenchymal stem cells (MSCs) in vitro. The cells were positive for the MSC markers and were able to differentiate in osteogenic and adipogenic directions. The cells grew robustly in an osteoconductive material, Bolheal (serum glue), and also proliferated well in culture medium supplemented with autologous serum. Therefore, the bone dust is a good candidate for the alternative source of stem cells other than bone marrow aspirate to increase the safety of the TLIF procedure.

Topics: Biomarkers; Bone Marrow Cells; Bone Substitutes; Bone Transplantation; Cell Differentiation; Cell Separation; Cells, Cultured; Female; Fibrin; Humans; Immunophenotyping; Low Back Pain; Male; Mesenchymal Stem Cells; Spinal Fusion; Tissue Adhesives; Transplantation, Autologous

It has been reported that plasma fibrinolytic activity is abnormal in some patients with chronic low back pain. In an attempt to confirm this finding we studied 22 patients with chronic mechanical low back pain and compared them with 18 healthy controls who denied symptoms of back pain. Factors known to interfere with plasma fibrinolysis such as age, weight, seasonal and diurnal variation, exercise, smoking and drugs were controlled as far as possible. Plasma fibrinogen was significantly higher (2.8 versus 2.3 g/l, P < 0.005) in patients than in controls, but there were no significant differences in the median plasma concentrations of euglobulin clot lysis time, fibrin plate lysis area, plasminogen, alpha-2-antiplasmin, tissue plasminogen activator activity, and antigen, tissue plasminogen activator inhibition and plasminogen activator inhibitor-1 antigen level. The results fail to confirm abnormalities of plasma fibrinolytic activity in a group of unselected cases of chronic low back pain.

Topics: Adult; Aged; Aging; alpha-2-Antiplasmin; Body Weight; Female; Fibrin; Fibrinolysis; Humans; Low Back Pain; Male; Middle Aged; Plasminogen; Plasminogen Activator Inhibitor 1; Seasons; Serum Globulins; Tissue Plasminogen Activator