World neurosurgery · 2026
Safety and Feasibility of Intradiscal Autologous Bone Marrow Aspirate Concentrate at the Time of Lumbar Microdiscectomy: A Prospective Pilot Study.
СтатьяНазвание и аннотация: Перевод в очереди
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Fidai Alikhan B, Berger Jessica, Robayo Anthony, Kartal Ahmet, Ikwuegbuenyi Chibuikem A, Cardenas Ashley, Dyke Jonathan P, Hussain Ibrahim, Bonassar Lawrence J, Härtl Roger
Аннотация
OBJECTIVE: Lumbar microdiscectomy improves pain and disability in patients with lumbar disc herniation, but it does not restore disc biology, and recurrent herniation at the index level remains a clinically important limitation. Intradiscal autologous bone marrow aspirate concentrate (BMAC) has growing preclinical support as a potential biologic adjunct, but human safety data remain limited. This study evaluated the safety and feasibility of intradiscal BMAC administration at the time of lumbar microdiscectomy.
METHODS: Patients underwent lumbar microdiscectomy and 1 mL intradiscal autologous BMAC with 1-year follow-up. Primary outcomes were injection- or procedure-related complications, readmissions, reoperations, and same-site recurrence; secondary outcomes were Oswestry Disability Index (ODI) and Numeric Rating Scale (NRS) for leg and back pain; exploratory quantitative magnetic resonance imaging (qMRI; T1-rho, T2) screened for adverse compositional changes.
RESULTS: 27 adults underwent lumbar microdiscectomy with concurrent intradiscal BMAC injections. No intraoperative or postoperative injection- or procedure-related complications occurred. Same-site recurrence occurred in 1/27 (3.7%) and was managed without reoperation. Patient-reported outcome measures (PROMs) were completed by 18/27 (67%), and qMRI was obtained in 16, including 6 with complete imaging through 1 year. Among patients with completed PROMs, mean ODI, NRS-leg, and NRS-back improved at 1 year, but the uncontrolled design precludes efficacyinference. No adverse changes in T1-rho or T2 were observed through 1 year.
CONCLUSIONS: In this single-center prospective pilot, intradiscal BMAC at the time of microdiscectomy was safe and feasible, with no injection-related harm through 1 year and one same-site recurrence. Without a control group and with incomplete follow-up, findings are preliminary safety data, not evidence of efficacy or reduced recurrence risk. These results support a multicenter study with longer follow-up and a controlled comparison group.
METHODS: Patients underwent lumbar microdiscectomy and 1 mL intradiscal autologous BMAC with 1-year follow-up. Primary outcomes were injection- or procedure-related complications, readmissions, reoperations, and same-site recurrence; secondary outcomes were Oswestry Disability Index (ODI) and Numeric Rating Scale (NRS) for leg and back pain; exploratory quantitative magnetic resonance imaging (qMRI; T1-rho, T2) screened for adverse compositional changes.
RESULTS: 27 adults underwent lumbar microdiscectomy with concurrent intradiscal BMAC injections. No intraoperative or postoperative injection- or procedure-related complications occurred. Same-site recurrence occurred in 1/27 (3.7%) and was managed without reoperation. Patient-reported outcome measures (PROMs) were completed by 18/27 (67%), and qMRI was obtained in 16, including 6 with complete imaging through 1 year. Among patients with completed PROMs, mean ODI, NRS-leg, and NRS-back improved at 1 year, but the uncontrolled design precludes efficacyinference. No adverse changes in T1-rho or T2 were observed through 1 year.
CONCLUSIONS: In this single-center prospective pilot, intradiscal BMAC at the time of microdiscectomy was safe and feasible, with no injection-related harm through 1 year and one same-site recurrence. Without a control group and with incomplete follow-up, findings are preliminary safety data, not evidence of efficacy or reduced recurrence risk. These results support a multicenter study with longer follow-up and a controlled comparison group.