Autologous Disc Chondrocyte Transplantation

[Frankg]

Amazing how in the US we are debating first and second generation ADR while in Europe the national health insurance programs will cover a therapy that makes ADR look downright primitive:

Reimbursement

Therapy with ADCT

The decline of American medicine thanks to our Republican-protected for-profit health system, is real ACP Newsroom - America’s Health Care System in State of Decline

[ZorroSF]

you might want to re-read that. they don't cover the incubating period or storage, just the transplant itself, which is very surprising nonetheless. Also there are no raving results with this procedure otherwise everyone would be on the bandwagon.

Each country of europe has it's own healthcare system and most do not have a blanket policy of covering ADR. ADR is beginning to be covered in certain areas and the european healthcare system usually looks at its efficacy over a 5 year period. As I recall they were just beginning to allow certain doctors in England and France in 2006 to perform the surgery.

I am not a fan of the us healthcare system. it's a privelidge system that is slowly fading away. We have the technology it's just not accessible to the general public unless your employer covers it or you're in your 20's.

I used to be a democrat and blame the gop for the healthcare crisis, but I've since learned almost all politicians have screwed us, and it's the entire middle class and the working poor who have subsidized their greedy ways.

My friends in europe don't love their system, but they love the fact they have access to the system and won't go bankrupt trying to pay bills even if they have to wait a long time to get an MRI. Each country has their own way of collecting taxes to subsidize it, and this last wallstreet crisis has forced their gov't to reduce the total coverage offered to the citizens.

I do think it's our taxpayer responsibility to subsidize the hospitals and general care practitioners and R&D for new therapies instead of leaving it up to the greasy fingered scumbags on wallstreet and the filthy hedge funds to determine who receives investment money and who doesn't.

well sorry for the rant. I do understand your frustration cause I'm in a bad situation myself. I just wanted to let everyone know it's not as easy as you think trying to get high end healthcare over there.

[Frankg]

ZorroSF,

Thanks for that message. I agree with just about all of it. One of the few advantages to being in the position we are in, i.e. needing adr surgery, is that it forces you to become aware of the unbelievable decline in health care that has occurred in this country over the past couple of decades.

Regarding autologous condrocyte transplantation, there's something out there right now that seems even better in that cells incubate invivo. It's rhgdf-5. If you don't already know about it, it's essentially a growth factor that is injected directly into an aging intervertebral disc which stimulates the condrocytes there to proliferate and become active. This, according to some early trials, results in significant height increase, etc.

I imaging every ADR company sees this as a big threat. What else could explain the fact that it seems to be going nowhere. I'd go anywhere and pay anything (which in my case isn't much) for this treatment right now.

[Toebin]

Totally agree Frankg,

The future of spinal care lies in the biologicals and NOT in artificial pieces n parts that can be inserted into a human being. So much work has been done in finding the right triggers to turn off and on self healing disks and stem cells that can heal the broken parts of a spine that it will be the natural course to follow in the future.

Unfortunately the money trail in medicine will attempt to stifle what is best for patient outcomes if that new and improved treatment interferes with the bottom line profits of the big medical firms.

A sad but true state of affairs in healthcare today

[dlib44]

Would love if this could regrow my L5-S1.
Growing Body Parts - 60 Minutes - CBS News

[Slackwater]

Originally Posted by dlib44

Would love if this could regrow my L5-S1.
Growing Body Parts - 60 Minutes - CBS News

Agree in concept with biologics, more to be said about testing. However, notwithstanding the level of testing desired by some, AAOS, FDA, ..., there will be volunteers. I got the passport renewed assuming an overseas alternative with biologics or ADR would be more feasible than US-based surgical treatment, as others have done.

Medicine, spine treatment, orthopaedics in 2-to-5, 10 -> 100 years from now will be different. The patient perspective, given a set of symptoms, ODI / VAS metrics, medication usage, ..., can be more focused to less than six (6) months (my right hand is up).

Growth factors may be used in the future, or cell transplantation, or when you have a physical status where there will not be enough nutrition to the Intervertebral Disc in a status beyond mild disc degeneration, moderate or sever, surgery (adr/tdr - fusion) may/will be done.

Declining nutritional transport appears to be a critical event responsible for the changes in central disc cells and the matrix. The disc cells rely on diffusion and convection of nutrient waste products through the matrix, most likely partially through the the cartilaginous endplate and annulus fibrosus. The supply of nutrients decline and the Ph is decreased (rise in lactate concentration). A lower pH compromises cell metabolism and biosynthetic functions; it can cause cell death.


Agree with GDF-5 is a candidate therapy. A single growth factor will improve status, be it GDF-5 (CDMP1), TGF-B1, BMP-7 (OP-1), ..., assuming the animal models scale to humans.

May I suggest there will be a mix of drugs, protein injections, gene therapy, cell therapies, scaffolds, ..., that will be in the therapeutic recommendation list.

best wishes for all,