Regenerative Medicine in Spine Care: Clinical Potential of Mesenchymal Stem Cells for Chronic Low Back Pain

Chronic low back pain (CLBP) remains one of the leading causes of disability worldwide, with current treatments often providing only symptomatic relief.Among emerging regenerative strategies, mesenchymal stem cell (MSC) therapy has garnered significant attention for its ability to address the underlying pathophysiology of CLBP, particularly intervertebral disc degeneration (IDD).This paper reviews the therapeutic mechanisms of MSCs, including their capacity for disc regeneration, immunomodulation, and pain alleviation via paracrine signaling and anti-inflammatory effects.Preclinical studies demonstrate that MSCs restore disc structure, inhibit neuroinflammation, and enhance extracellular matrix composition.Human clinical trials further indicate that both autologous and allogeneic MSCs can lead to significant reductions in pain and functional disability, with minimal adverse effects.While promising, MSC therapy faces challenges related to variability in cell sources, delivery methods, regulatory frameworks, and long-term outcome data.Comparisons with other regenerative approaches-such as platelet-rich plasma (PRP), gene therapy, and tissue engineering-highlight MSCs' unique advantages in cellular replacement and sustained modulation of the disc environment.Future directions emphasize the integration of MSCs with biomaterials and PRP in combination therapies, as well as the need for long-term, large-scale clinical trials to validate efficacy, optimize protocols, and ensure safety.