Degenerative disc disease (DDD) can cause severe low back pain, which will have a serious negative impact on the ability to perform daily tasks or activities. For the past few years, mesenchymal stem cell (MSC) transplantation has emerged as a promising strategy for the treatment of DDD. However, the clinical efficacy of MSC in the treatment of DDD still lacks clinical evidence and is controversial. We conducted a meta-analysis with randomized controlled trials (RCTs) to evaluate the clinical efficacy and safety of MSC transplantation in patients with DDD. We searched major databases using terms from the database’s inception through March 2021. The Cochrane bias risk assessment tool was used to assess quality. The analysis showed that MSC therapy could decrease visual analog scale (VAS) scores (, , ) and Oswestry Disability Index (ODI) scores (, , ). The outcomes with subgroup analysis showed that MSC therapy could decrease VAS scores in 3 months (), 6 months (), 12 months (), and ≥24 months () and ODI scores in ≥24 months (). Pooled analysis showed that MSC therapy has a higher ratio of patients at most thresholds but particularly at the MIC (minimally important change) () and CSC (clinically significant change) () in VAS and MIC () and CSC () pain responders in ODI. Adverse events (AE) of treatment-emergent adverse events (TEAE), back pain, arthralgia, and muscle spasms were not statistically significant between the two groups. However, our further statistical analysis showed that MSC therapy may induce AE of TEAE related to study treatment (, , ). In conclusion, this study pooled the main outcomes and showed that MSC therapy could significantly decrease VAS and ODI scores in patients with DDD. Distinctly, the findings of this meta-analysis suggest a novel therapeutic strategy for patients with chronic low back pain (LBP) and lumbar dysfunction by DDD.

中文翻译：

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人类间充质干细胞治疗椎间盘退行性疾病的临床疗效和安全性：随机对照试验的系统评价和荟萃分析

退行性椎间盘疾病 (DDD) 会导致严重的腰痛，这将对执行日常任务或活动的能力产生严重的负面影响。在过去的几年中，间充质干细胞 (MSC) 移植已成为治疗 DDD 的有前景的策略。但MSC治疗DDD的临床疗效尚缺乏临床证据，存在争议。我们对随机对照试验 (RCT) 进行了荟萃分析，以评估 MSC 移植对 DDD 患者的临床疗效和安全性。我们使用从数据库开始到 2021 年 3 月的术语搜索了主要数据库。使用 Cochrane 偏倚风险评估工具来评估质量。分析表明，MSC治疗可以降低视觉模拟量表（VAS）评分（, , )和 Oswestry 残疾指数 (ODI) 分数 (, , ）。亚组分析结果显示，MSC治疗可在3个月内降低VAS评分（), 6 个月 (), 12 个月 ()，并且≥24 个月 ()和 ≥24 个月的 ODI 分数 (）。汇总分析表明，MSC 治疗在大多数阈值下具有更高的患者比例，尤其是在 MIC（最不重要的变化）下（)和 CSC（临床显着变化）（)在 VAS 和 MIC ()和 CSC () ODI 中的疼痛反应者。治疗出现的不良事件 (TEAE)、背痛、关节痛和肌肉痉挛的不良事件 (AE) 在两组之间没有统计学意义。然而，我们进一步的统计分析表明，MSC 治疗可能会诱发与研究治疗相关的 TEAE AE。, , ）。总之，本研究汇总了主要结果，并表明 MSC 治疗可以显着降低 DDD 患者的 VAS 和 ODI 评分。显然，这项荟萃分析的结果提出了 DDD 对慢性腰痛 (LBP) 和腰椎功能障碍患者的新治疗策略。