At the Centeno-Schultz Clinic we acknowledge that low back and leg pain can be disabling. It can make the simplest of tasks virtually impossible.
This was the case with TA who could barely walk without assistance. In caring for her children she had sustained an abrupt onset of severe lower back pain that traveled down her leg down to her foot. The pain was electrical in character and aggravated by virtually movement. MRI was signficant for lumbar disc degeneration and disc protrusion. Physical exam was significant for musculoskeletal distress, weakness and numbness in the big toe and lateral aspect of foot and severe pain with straight leg raise.
As opposed to an epidural injection with high doses of steroids, TA underwent x-ray guided epidural injection with Regenexx PL-M which contains platelet derived growth factors intended to decrease the inflammation and increase the blood flow to the injured lumbar disc and inflamed nerve root. PL-M is the newest platelet therapy at Regenexx and has demonstrated improved mesenchymal stem cell growth when compared to commonly used bed side centrifuge PRP concentrates.
TA e-mailed me yesterday detailing her clinical success. Graciously she has allowed me to share her comments.
“Hey there, Doc. I just wanted to thank you!!! my back is at least 80% better!!! once again life changing!!! I am once again able to be active. I don’t know what happened where my pain came back, but I can always count on you to fix me!!! thank you!!! you are my hero!!! : ) keep up the good work!!! “
Today I discussed the Biologic Response of Human Mesenchymal Stem Cells to various PRP (platelet rich plasma) preps at the AAOM conference. PRP has received signficant attention in the treatment of musculoskeletal and orthopedic injuries. At the Centeno-Schultz Clinic advanced platelet rich therapies are available for the treatment of common orthopedic conditions.
A previous blog (dirty little machine) outlined the problems associated with standard bedside centrifuge systems. Specifically the PRP is contaminated with RBC’s which can led to a number of issues including inflammation as evidenced by signficant postprocedure swelling. In contrast, Regenexx PL and SCP both of which are created by a cell biologist are free of RBC’s.
Are there other differences?
The is a striking difference in the ability of different PRP concentrates to grow human mesenchymal stem cells. PRP concentrates with RBC’s were compared with Regenexx PL and SCP in their ability to grow human mesenchymal stem cells in culture. Both Regenexx PL and SCP are free of RBC contamination.
There was no growth of stem cells with bedside centrifuge PRP preps that contained RBC’s. In contrast Regenexx PL and SCP demonstrated signficant stem cell growth.
The picture tells the story.
After 6 days in culture there was mesenchymal stem cell growth as reflected by the presence of colonies (MCU) in PRP preps that contained no RBC’s. This is seen in top and bottom pictures on left. In contrast there was no growth the PRP prep that contained RBCs as seen in upper right hand picture.
The presence of RBC’s in platelet concentrates make a difference. As a patients or provider choose wisely.