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J Am Acad Orthop Surg, Vol 16, No 6, June 2008, 312-319.
© 2008 the American Academy of Orthopaedic Surgeons
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Gene Therapy for the Treatment of Degenerative Disk Disease

Mark G. Hubert, MD, Gianluca Vadala, MD, Gwendolyn Sowa, MD, PhD, Rebecca K. Studer, PhD and James D. Kang, MD

Dr. Hubert is Resident, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA. Dr. Vadala is Research Fellow, Department of Orthopaedic Surgery, University of Pittsburgh. Dr. Sowa is Assistant Professor, Department of Orthopaedic Surgery and Department of Physical Medicine & Rehabilitation, University of Pittsburgh. Dr. Studer is Research Faculty, Department of Orthopaedic Surgery, University of Pittsburgh. Dr. Kang is Associate Professor, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine.

Reprint requests: Dr. Kang, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Suite 1010, 3471 Fifth Avenue, Pittsburgh, PA 15213.

Dr. Kang or a member of his immediate family has received research or institutional support from Medtronic Sofamor Danek. None of the following authors or a member of their immediate families has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Vadala, Dr. Hubert, Dr. Sowa, and Dr. Studer.

Perspectives on Modern Orthopaedics articles provide an objective appraisal of new or controversial techniques or areas of investigation in orthopaedic surgery.

Recent biologic and biochemical advances have furthered our understanding of the complex environment of the intervertebral disk. This new understanding has allowed researchers to pursue novel treatments of intervertebral disk degeneration, targeting the biochemical pathways involved in the degenerative cascade. Gene therapy has shown much promise in this regard. Many new targets for gene therapy in the intervertebral disk have been identified, such as TGF-β1, TIMP-1, and LMP-1. In addition, new vectors, such as the adeno-associated virus, are being investigated for use in intervertebral disk applications. Cell-based therapy has also shown significant promise in the biologic treatment of intervertebral disk degeneration. With continued efforts, gene therapy may prove to be an extremely powerful tool in the treatment of intervertebral disk degeneration.






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Copyright © 2008 by the American Academy of Orthopaedic Surgeons.