Autologous mesenchymal stem cell transplantation for spinal fusion: 10 years follow-up of a phase I/II clinical trial.

Posterolateral spinal fusion is the standard surgical approach for patients with degenerative disc disease. In our previously published article, we reported a 5-years follow-up of a phase I/II clinical trial in patients undergoing spinal fusion with autologous mesenchymal stem cells (MSCs) embedded in tricalcium phosphate. In the current manuscript, we have updated the results with a 10-year follow-up, the longest reported to date in this setting. After clinical and radiological evaluation, safety of the procedure was further confirmed in all 11 treated patients, with no evidence of tumor, infection, inflammatory reaction, or heterotopic ossification related to the administration of MSCs. Regarding clinical efficacy, low back pain and radicular pain (both assessed by the visual analogue scale-VAS), and the Owestry Disability Index remained significantly lower compared to pre-intervention. Radiologic evaluation demonstrated spinal fusion in all cases, improving over time. Finally, quality of life improved significantly also during follow-up. In summary, the use of tricalcium phosphate-embedded autologous MSCs with lumbar posterolateral arthrodesis is safe and potentially provides long-term benefits for 10 years.

Cold abscess of the chest wall: A diagnostic challenge.

Tuberculosis of the chest wall represents less than 5% of cases of musculoskeletal tuberculosis. We present the case of a patient with a cold abscess in the pectoral region due to Mycobacterium tuberculosis. A 29-year-old male of Senegalese origin reported a progressive increase in size of the right hemi-thorax without trauma or previous effort. A liquid collection of 14cm on the major axis, between the pectoralis major muscle and the costal wall, was demonstrated on magnetic resonance imaging. Surgical debridement revealed a marked granulomatous inflammatory reaction with focal necrosis; PCR was positive for M. tuberculosis complex and culture subsequently grew M. tuberculosis complex. Specific treatment for tuberculosis achieved a good clinical outcome. The diagnosis of tuberculosis of the chest wall is always difficult, being a clinical challenge.