Study Reveals Discovery of Unique Vertebral Stem Cells

In a study published in Nature, researchers from the Hospital for Special Surgery (HSS) and Weill Cornell Medicine have identified a new stem cell uniquely present in the spine. Vertebral stem cells, distinct from other stem cells in the body, hold the key to understanding a range of conditions affecting the spine—including its higher incidence of cancerous tumor metastases, particularly from breast, prostate, and lung cancers. 
 
Physicians have traditionally believed all bones form through ossification. But this study, led by primary investigator Matthew Greenblatt, M.D., Ph.D., associate professor of pathology and laboratory medicine at Weill Cornell Medicine and assistant scientist in the HSS research division, and clinical collaborator Sravisht Iyer M.D., spine surgeon at HSS, found that certain vertebral skeletal stem cells play a unique and formative role in the spinal vertebrae’s development and life cycle. Specifically, the investigators identified a stem cell that is responsible for forming vertebral bone. Their research was made possible by support from a Pershing Square Foundation Cancer Research Prize and a special program established by the Anna-Maria and Stephen Kellen Foundation and Marina Kellen French, vice president of the Foundation and an HSS trustee, that provides support for clinicians pursuing research as a significant component of their careers.
 
“Understanding how vertebrae develop will help us more effectively treat patients, screen them before surgical intervention, and will ultimately lead to more effective preventive care and optimized bone health,” Iyer said. “The identification of this unique stem cell in the spine has the potential to significantly enhance our patients’ outcomes in spine fusion surgery—a procedure performed hundreds of thousands of times in the United States each year—because it may allow for us to screen for problems ahead of time. The findings may also advance care for people with osteoporosis and, specifically, the 30 percent to 50 percent of the global population who suffer a vertebral fracture at some point in their lives.”

This significant finding carries profound implications for spine health, including spinal healing, degeneration, treatment approaches, comprehension of degenerative spine disorders, and the potential for breakthroughs in preventing and treating vertebral osteoporosis and cancer metastasis.
 
By manipulating bone-like “organoids” made from vertebral stem cells, this study also explored the disparities in metastasis rates between spinal bones and long bones, which include bones of the thigh, leg, arm and forearm. “Traditionally, it was believed that cancer cells were attracted to the spine due to directed blood flow. However, our discovery of this vertebral stem cell provides a likely explanation of why some cancers most often spread to the spine,” Dr. Greenblatt stated. “We predict this discovery will lead to the targeting of these cells to disrupt the function and ultimately reduce the spread of cancer to the spine.”
 
The research team for this study included Jun Sun, Ph.D., first author and a postdoctoral associate at Weill Cornell; Kyle Morse, M.D., an orthopedic surgery resident at HSS; and Lingling Hu, Ph.D., researcher at HSS. The discovery could potentially impact patient care worldwide. Armed with insights into spine development and evolution, physicians will be able to tailor treatments and surgical intervention with more precision, with hope for improved patient outcomes across the board.
 
HSS is a leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 14th consecutive year), No. 2 in rheumatology by U.S. News & World Report (2023-2024), and the best pediatric orthopedic hospital in New York, New Jersey, and Connecticut by U.S. News & World Report “Best Children’s Hospitals” list (2023-2024). Founded in 1863, the Hospital has the lowest readmission rates in the nation for orthopedics, and among the lowest infection and complication rates.  An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut, and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. In addition, more than 200 HSS clinical investigators are working to improve patient outcomes through better ways to prevent, diagnosis, and treat orthopedic, rheumatic and musculoskeletal diseases. The HSS Innovation Institute works to realize the potential of new drugs, therapeutics and devices.