Dr. Neil Riordan on health: what the evidence says · JRE #1066
“a study out of Europe just came out a couple months ago, and it showed about 50% of the patients had their discs become normal on MRI after treatment. So it's not every case, but I'd take a 50-50 shot versus having a fusion, right?”
What the evidence says
Riordan is likely referring to a 2017 Spanish randomized controlled trial (Noriega et al., published in Transplantation) of intradiscal allogeneic mesenchymal stromal cell (MSC) injection for degenerative disc disease, the best-known European trial of this kind circulating at the time of the podcast. That study does not report that ~50% of discs became 'normal' on MRI: in a cohort of only 24 patients, disc degeneration graded by the Pfirrmann scale improved in the MSC group and worsened in controls, while clinical improvement (pain/disability) was seen in a subset described as 40% of the cohort, not a full return of discs to normal appearance. A larger, more rigorous European follow-up trial (RESPINE, a 2024 French multicentre, double-blind, placebo-controlled RCT with 114 patients) tested the same allogeneic MSC approach and found no significant difference between MSC injection and sham placebo at 12 months on either clinical response rates (74% vs 69%, p=0.77) or secondary MRI-based measures. Taken together, current evidence shows small early-phase signals of benefit in some patients but no robust confirmation that intradiscal stem cell injection restores discs to a 'normal' MRI appearance in half of cases, and the larger, better-controlled trial found no advantage over placebo. The claim overstates both the strength and the specificity (MRI 'normalization') of the supporting data.
- Intervertebral Disc Repair by Allogeneic Mesenchymal Bone Marrow Cells: A Randomized Controlled Trial - PubMed · government
- Allogenic bone marrow-derived mesenchymal stromal cell-based therapy for patients with chronic low back pain: a prospective, multicentre, randomised placebo controlled trial (RESPINE study) - PubMed · government