Patients with a slipped disc could be cured by transplant

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Surgeons have pioneered a radical cure for the slipped disc, a common cause of back pain, by using transplants from donors.

In the first operation of its kind, orthopaedic specialists in Hong Kong replaced slipped discs in five patients, who had suffered long-standing pain, with discs removed from three women aged between 20 and 30 who had died in accidents.

The operations were performed between March 2000 and January 2001 and the five patients - four men and a woman then aged between 41 and 56 - were followed up for five years. The results, reported in The Lancet today, show the transplants were still functioning well in all the patients and their pain had improved. None of the patients needed immunosuppressant drugs normally given to transplant recipients for life.

A slipped disc occurs when the jelly-like disc of cartilage that acts as a cushion between two vertebrae in the spine, slips or prolapses so it is pressing on the nerves causing the muscles of the back to go into spasm.

In severe cases the disc of cartilage has to be removed surgically and in some cases the bones of the spine are fused to prevent further movement.

Artificial discs have been tried as a substitute but have not proved successful. Doctors at the University of Hong Kong and the Navy General Hospital in Beijing carried out the first human transplants after experimenting on animals.

Writing in The Lancet they say they have done transplants on a second group of patients based on their success with the first five. A commentary in the journal by two specialists from the National Centre for Scientific Research in Paris hails the advance and says it could be an "attractive alternative" to current treatments.

Chris Bulstrode, professor in orthopaedic surgery at Oxford University, said the operation was a remarkable advance but warned it was too early to judge its future application. "We have been caught before by the enthusiasm of surgeons for their own techniques and we will have to wait for independent validation."

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