Regenerative Medicine and Surgery

Cell therapy is a branch of regenerative medicine that involves transplanting human cells to replace or repair damaged tissues and cells. Depending on the objective, the cells can come from the patient, a donor, or be modified before administration. While traditional drugs are chemical compounds designed to alter a biological process, cell therapy uses living cells as ‘living medicines’ to treat a specific condition.

Types of cell therapy

• Autologous: the cells come from the patient’s own body.
• Allogeneic: the cells come from a donor.
• Genetically modified cell therapy: cells are modified in the laboratory to improve their function, as is the case with CAR-T therapy for cancer.
• Depending on the therapeutic needs, these can be administered by infusion or injection, local application, or used together with scaffolds in Regenerative Medicine.

Stem Cell Therapy (STEM CELLS, MESEMCHYMAL/STROMAL CELLS): This therapy uses stem cells to replace damaged cells, promote tissue repair, or emit signals that promote healing. Stem cells have the ability to self-renew through multiplication and differentiate into specialized cell types, making them fundamental to regenerative medicine and transplantation.

The main sources of stem cells are embryonic tissue, adult tissues, perinatal tissues, and reprogrammed adult cells. In clinical practice, they can be obtained autologously, allogeneically, or genetically modified in a laboratory.

Adipose tissue isolation:

Surgical procedures are performed in the operating rooms of VERTEBRA SpinePain and Regenerative SURGERY CENTERS, equipped with the latest technology, under Monitored Anesthetic Care (ASA II), using intravenous sedation and supplemental nasal oxygen.

Adipose tissue is removed from the upper outer quadrant of both gluteal regions using image-guided tumescent liposuction, with a mixture of saline solution, lidocaine (an anesthetic), and epinephrine (to constrict blood vessels). Unlike conventional liposuction, which often requires general anesthesia, tumescent liposuction is typically performed under sedation, minimizing or eliminating postoperative complications such as nausea and vomiting, as well as significantly reducing blood loss.

Isolation, Culture, Biobanking and Preparation of SVF and MSC for Cell Therapy

The extracted adipose tissue is processed in the Clean Room of VERTEBRA SpinePain and Regenerative SURGERY CENTERS, which has a biosafety level III (BSL-III) and complies with GLP/GMP regulations. Here, the Stromal Vascular Fraction (SVFs) and Mesenchymal Stem/Stromal Cells (MSCs) are isolated, cultured, and cryopreserved.

Isolation and Inoculation of SVF

On the day of extraction, the adipose tissue is processed using GMP-grade reagents to isolate the Stromal Vascular Fraction (SVF) through mechanical and enzymatic digestion. The cell count is verified with an automated digital counter. For the therapeutic phase, one-third of the isolated cells are processed under strict GLP/GMP compliance and transported to the operating room in sterile, labeled, and patient-specific containers. Finally, the cells are combined with autologous Leukocyte-Rich Platelet-Rich Plasma (LR-PRP) and administered to the target sites via image-guided inoculation into the target tissues, which are previously defined using MRI and specifically diagnosed using SPECT-CT imaging.

Cell Expansion and Cryopreservation

The remaining two-thirds of the cell suspension are cultured in the BSL-III Cleanroom to isolate and purify Adipose Tissue-Derived Mesenchymal Stem Cells (AD-MSCs). Following optimized protocols, the cultures are continuously monitored to assess growth kinetics and sterility using microscopic and microbiological assays. Upon reaching the desired cell density, a portion is cryopreserved by programmed freezing at -80 °C in an ultra-low temperature freezer, followed by long-term storage in our Biobank at -196 °C. The remaining cells are expanded for a second intervention, typically scheduled 30 to 45 days later. On the day of treatment, these cells are harvested under strict GLP/GMP aseptic conditions, combined with autologous LR-PRP, and safely administered under image guidance using minimally invasive procedures.

Scheduled Therapeutic Interventions

Future treatments are scheduled based on the patient’s clinical and radiological evolution. Once specific therapeutic needs are determined, the necessary dose of AD-MSCs is calculated and prepared within the BSL-III Cleanroom, strictly adhering to GLP/GMP standards.

Trust and Transparency for the Patient

Quality Assurance: Every material and consumable used in our process meets strict GMP quality standards. The entire procedure is performed under GLP guidelines in compliance with GMP. Microbiological sterility tests are conducted at regular intervals to ensure maximum safety, asepsis, and efficacy of Cell Therapy.

Treatment Certificate

At the end of treatment, each patient receives a Cell Therapy Certificate with a barcode. This document provides full traceability and transparency, detailing the processing metrics and quality controls of their specific biological sample.

Herniated disc

Deterioration of the intervertebral discs can cause a protrusion that inflames the nerve roots, resulting in radiating pain and potential neurological problems.
Regenerative medicine and cell therapies are used as minimally invasive biological injections for pain related to herniated discs, primarily to reduce inflammation and promote tissue repair. They are generally considered for patients who wish to avoid or delay surgery and who do not have severe neurological deficits. The benefits are typically described as pain reduction, improved function, and gradual recovery over weeks or months. Because it is an autologous therapy, the risks of adverse effects and postoperative complications are extremely low.

Lower back pain and sciatica

Lower back pain is synonymous with “lumbalgia” and “lumbago.” It refers to pain in the lower back, from the bottom of the ribs to the buttocks.

Sciatica: When lower back pain radiates to the lower extremities, it is popularly known as “sciatica”.

Regenerative medicine and cell therapies are being extensively explored as complementary options for lower back pain and sciatica, especially when the origin is related to disc degeneration or inflammation of spinal tissues. Their aim is not only to relieve pain, but also to promote the reduction of inflammation and the repair and regeneration of the tissues involved (connective and neural).

Lumbar stenosis

Lumbar spinal stenosis is the narrowing of the spinal canal in the lower back, which compresses nerve roots and can cause leg pain, numbness, weakness, and difficulty walking; it usually develops gradually with age. Symptoms include leg pain, cramping, tingling, or weakness brought on by standing or walking, and relieved by sitting or bending forward. Severe compression can cause bladder or bowel dysfunction, or progressive neurological deficits requiring urgent medical attention.
Regenerative medicine and cell therapy aim to repair underlying degeneration, reduce inflammation around compressed nerves, and potentially repair small tears in spinal discs or strengthen lax ligaments. Studies show that LR-PRP can be effective for pain relief and functional improvement, especially when combined with mesenchymal stem cell (MSC) therapy, which involves injecting MSCs into the disc or cavity to help regenerate damaged cartilage and disc material.

Vertebral fractures

Vertebral fractures are breaks in the bones that make up the spine (vertebrae). These can range from small compression fractures (common in cases of osteoporosis) to high-energy burst fractures or fracture-dislocations that can compromise the spinal cord or nerves. They cause acute back pain and kyphosis, and if left untreated, can lead to radiculopathy, weakness, or bladder and bowel dysfunction.
For patients who are not candidates for spinal cementation and whose pain is not controlled with available medication, regenerative medicine and cell therapy are options. When administered to the vertebral body, these therapies stimulate bone formation and modulate inflammation, restoring bone mass, strength, and spinal stability.

Neck pain

Neck pain refers to pain felt in the back and sides of the neck, the upper part of the shoulders, and very often the back of the head and the head (headache). It can extend to the area between the shoulder blades. It is a very common type of pain, even among young people.

Cervicobrachialgia

This occurs when neck pain is accompanied by pain in the arm, forearm, hand, and fingers. Neck pain can be very intense and radiate down the arm. Sometimes, the radiating pain in the arm or hand is so severe that it overwhelms the neck pain itself, potentially becoming highly debilitating.

Regenerative Medicine and Cell Therapy

These therapies target discogenic pain, facet joint arthropathy, ligament injuries, and inflammatory pain around the cervical structures. By releasing growth factors, they stimulate cellular repair and reduce inflammation in facet joints and ligaments. In more advanced degenerative cases, they activate a regenerative process in deep tissues.

Sacroiliac pain

The sacroiliac (SI) joint is a common, though often overlooked, source of lower back and buttock pain, accounting for 15% to 30% of cases of chronic nonspecific low back pain. Because the primary function of the sacroiliac joint is to act as a shock absorber between the spine and pelvis, any dysfunction in this area can significantly impair mobility.

Regenerative Medicine and Cell Therapy aim to stabilize the sacroiliac joints and ligaments by immunomodulating the biological response, thereby reducing inflammation and promoting the repair and regeneration of affected tissues.

Back pain

The thoracic spine is located between the end of the cervical spine and the ends of the ribs. Pain in this region may be limited to the back or radiate to the front of the chest. It is usually due to degenerative or inflammatory conditions of the thoracic spine. Pain caused by fractures of the thoracic vertebrae is also common, especially in the presence of osteoporosis.
Regenerative medicine and cell therapy aim to reduce inflammation in affected structures, thereby inhibiting nerve compression. They also facilitate healing by promoting repair and regeneration in areas with degenerative processes or potential fractures.

Teaching

Vertebra SpinePain and Regenerative SURGERY CENTERS collaborates through teaching activities at several universities on different continents:
University of Barcelona (UB). Barcelona, ​​Catalonia, Spain.
Semmelweiss University. Budapest, Hungary.
National Taiwan University. Medical College Hospital. Taipei, Taiwan (ROC)
National Seoul University. Seoul, South Korea.
Abaçidem University. Istanbul, Türkiye.
Texas TechUniversity. Lubbock, Texas, USA
New York & New Jersey Pain Societies. Albert Einstein Med. College. NY, USA
World Institute of Pain. NC, USA

Practical training

We also welcome students from both public and private universities, providing the essential practical training needed to pursue a career in the scientific field.