International Orthopaedics

, Volume 43, Issue 4, pp 995–1002 | Cite as

The future of disc surgery and regeneration

  • Zorica BuserEmail author
  • Andrew S. Chung
  • Aidin Abedi
  • Jeffrey C. Wang


Low back and neck pain are among the top contributors for years lived with disability, causing patients to seek substantial non-operative and operative care. Intervertebral disc herniation is one of the most common spinal pathologies leading to low back pain. Patient comorbidities and other risk factors contribute to the onset and magnitude of disc herniation. Spine fusions have been the treatment of choice for disc herniation, due to the conflicting evidence on conservative treatments. However, re-operation and costs have been among the main challenges. Novel technologies including cage surface modifications, biologics, and 3D printing hold a great promise. Artificial disc replacement has demonstrated reduced rates of adjacent segment degeneration, need for additional surgery, and better outcomes. Non-invasive biological approaches are focused on cell-based therapies, with data primarily from preclinical settings. High-quality comparative studies are needed to evaluate the efficacy and safety of novel technologies and biological therapies.


Herniation Intervertebral disc Low back pain 


Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest. Disclosures outside of submitted work: ZB—consultancy: Xenco Medical, AO Spine; research support: SeaSpine (paid directly to institution); JCW—Royalties—Biomet, SeaSpine, Amedica, DePuy Synthes; Investments/Options—Fziomed, Promethean, Paradigm Spine, Benvenue, Nexgen, Vertiflex, Electrocore, Surgitech, Expanding Orthopedics, Osprey, Bone Biologics, Pearldiver; Board of Directors—North American Spine Society, North American Spine Foundation, AO Foundation, Cervical Spine Research Society; Fellowship Funding (paid to institution): AO Foundation.


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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryUniversity of Southern CaliforniaLos AngelesUSA
  2. 2.Department of Orthopaedic Surgery, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesUSA
  3. 3.Mayo ClinicPhoenixUSA

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