Systematic Review and Meta-Analysis: Efficacy of Biologic Therapies in the Treatment of Degenerative Disc Disease.

Introduction: Degenerative disc disease (DDD) is a chronic condition associated with substantial pain and disability, often inadequately addressed by traditional treatments. Biologic therapies such as stem cell therapy and platelet-rich plasma (PRP) injections offer potential alternatives by aiming to promote disc regeneration and alleviate symptoms.

Materials And Methods: A systematic review and meta-analysis were conducted to evaluate the efficacy of biologic therapies compared to conventional treatments for DDD. Pub Med, Cochrane Library, Embase, and Web of Science databases were searched up to December 2024. Inclusion criteria encompassed adult patients with DDD in randomized controlled trials (RCTs) and cohort studies comparing biologic therapies with conventional treatments. Outcome measures included pain relief (measured by visual analog scale), functional improvement (measured by Oswestry disability index), and disc regeneration (evaluated by magnetic resonance imaging). Data extraction and quality assessment were performed using established tools, with meta-analysis conducted using a random-effects model.

Results: Ten studies (7 RCTs and 3 cohort studies) involving 1,035 patients met the inclusion criteria. Biologic therapies demonstrated significant superiority over conventional treatments in pain relief (mean difference [MD] = -1.8, 95% confidence interval [CI]: -2.1--1.5, P < 0.001) and functional improvement (MD = -10.5, 95% CI: -12.3 t--8.7, P < 0.001). Furthermore, biologic therapies promoted enhanced disc regeneration compared to controls. Subgroup analyses revealed that stem cell therapy yielded greater efficacy than PRP in both pain relief and functional improvement outcomes. Longer-term follow-up (≥12 months) confirmed sustained benefits of biologic therapies.

Conclusion: Biologic therapies, particularly stem cell therapy and PRP, offer promising outcomes for managing DDD by significantly reducing pain, improving functional capacity, and enhancing disc regeneration compared to conventional treatments. These findings underscore the potential of biologic therapies as viable treatment options for DDD, though further high-quality RCTs with extended follow-up are necessary to consolidate these results and optimize clinical protocols.