Biologically based therapies for degenerative disc disease of the spine

Biologically based therapies aimed at preventing, arresting or reversing degenerative disc disease of the spine are currently being developed. Protein, gene and cellular therapies targeting the cells and matrix of the nucleus pulopsus lead the way based on the promise of similar 'biologics' in the treatment of other, nonspinal disease processes. In this perspective, the impetus for such interventions is discussed and the shortcomings of the current research program presented. It is concluded that the uniquely poor nutrition, harsh internal milieu and pathobiomechanics - perhaps representing irreversible processes - of the degenerating intervertebral disc, must be addressed prior to (or at the time of) intranuclear biological therapies to afford potential success.