How an almond-sized implant – which takes just 20 minutes to insert – can ease lower back pain with donor cells

An implant the size of an almond is used to treat chronic lower back pain.

The device, which is inserted at the base of the spine in just 20 minutes, is packed with donated bone cells.

These gradually seep out over weeks and months to form healthy, strong bone that stabilizes the sacroiliac joints – one of the largest joints in the body, connecting the pelvis to the spine. Their job is to provide stability and act as shock absorbers for the back and pelvis.

But almost one in three cases of chronic low back pain in the UK is due to excessive movement – ​​or destabilization – in these joints. This is usually the result of inflammation due to injury or wear and tear due to the joint disease osteoarthritis.

With the new implant, healthy bone cells ‘fuse’ with the damaged joint, creating strong new bone that restores stability and eases pain.

The sacroiliac joints connect the hip bones to the sacrum at the bottom of the spine.

These joints are reinforced with strong ligaments and bear the load of the upper body when you stand, sit, walk or jump and also assist in forward and backward bending.

If one or both joints become hypermobile (where the amount of movement is greater than it should be) or hypomobile (when there is too little movement), this can lead to chronic pain.

Hypermobility causes inflammation that affects the joint and surrounding nerves, while hypomobility – often caused by osteoarthritis – causes the bones in the hip and sacrum to rub together, causing pain.

Current treatments include steroid injections (to dampen inflammation), physiotherapy and painkillers.

In severe cases, surgeons fuse the joints (the sacrum and hip) together with metal implants to limit excessive movement. But it may take several weeks before patients can even get up properly after surgery.

The new implant, called the LinQ Fusion System and tested at Rush University in Chicago in the US, could be a simpler and more effective alternative.

Doctors apply a local anesthetic to the lower back and make a half-centimeter incision to insert a thin “loading tube” into the sacroiliac joint.

The device is then fixed in place before the tube is withdrawn.

The results of a recent study published in the Journal of Pain Research, which involved 159 patients with chronic low back pain aged 21 to 70 years, showed that one year after implantation, pain levels were reduced by more than 80 percent in about a third of cases. patients.

Many others experienced a 50 percent reduction in pain.

Patient mobility also improved. At the start of the trial, 82.1 percent were severely disabled or bedridden. After the trial, no one was bedridden and there was a threefold drop in the rate of severe disability.

Commenting on the research, Mike McNicholas, orthopedic surgeon at Liverpool University Hospitals, said: ‘Low back pain due to sacroiliac joint pathology is a huge burden on society. This promising, minimally invasive approach offers great hope for those suffering from the problem and their caregivers and families, who are also severely affected.”