Intradiscal mesenchymal stem cell therapy for degenerative disc disease: a systematic review and meta-analysis of randomized trials.

Abstract

Systematic review and meta-analysis. To investigate the efficacy and safety of intradiscal mesenchymal stem cell (MSC) injection for patients with degenerative disc disease (DDD). DDD is a common cause of chronic low-back pain (CLBP). Studies have shown that MSC therapy may have the potential to reverse the degenerative process. However, the evidence remains inconclusive. A comprehensive search of Europe PMC, Cochrane Library, Scopus, and Medline was conducted up to April 30, 2025, using relevant keywords. Randomized controlled trials (RCTs) comparing intradiscal MSC injections with sham/placebo in patients with DDD were included. Random-effects models were used to calculate the odds ratios and mean differences (MDs). Seven RCTs were included. MSC injection was associated with significantly greater reductions in Visual Analog Scale pain scores (MD, 6.67; 95% confidence interval [CI], -9.31 to -4.02; p<0.00001, I2=29%) and Oswestry Disability Index (ODI) (MD, -4.05%; 95% CI, -5.24 to -2.87; p<0.00001, I2=32%) compared with sham/placebo. The magnitude of improvement increased with longer followup. No significant differences were observed between groups in treatment-emergent adverse events (AEs), serious AEs, treatment discontinuation due to AEs, or mortality. Intradiscal MSC injection appears to be a safe and effective therapy, offering modest improvements in pain and function for patients with CLBP due to DDD who do not respond to conservative treatments.