Stemcelldoc's Weblog

September 29, 2009

Stem Cell Therapy for Lumbar Disc Protrusions

Lumbar disc protrusions can cause lower back and leg pain which can vary from mild to severe.

Today in clinic, I had the opportunity to followup with a patient who underwent autologous stem cell therapy using the Regenexx procedure.  He has kindly allowed me to share his experience. Patient is a 37-year-old male with longstanding lower back and leg pain.  The back pain was sharp in character, constant in duration, progressive in nature and aggravated by coughing, sneezing and flexion.  He would experience episodic pain which would incapacitate him.  Physical examination was significant for lower back pain aggravated by flexion, extension and straight leg raise.

Micro-discectomy and other surgical treatments were dismissed by the patient and his family.

 4 weeks after having his own stem cells injected into the L5/S1 disc along with platelet derived growth factors, the patient had significant reduction in his back and leg pain.  MRI prior to and after stem cell therapy was significant for a reduction in the L5/S1 protrusion which is illustrated below.

Lonnies MRI Revised  Sagitial

 

 

 

 

 

 

 

 

 

 

 

Lonnies MRI axial

September 27, 2009

Cryostorage: Freezing Your Stem Cells

Cryostorage 2Storage of adult autologous stem cells is appropriate when there is an interruption in therapy or the total number of cells available exceeds the number appropriate for a given application.

Freezing the cells in cryostorage is the standard.

International Cellular Medicine Society has established laboratory guidelines that address this specific and critical issue.  When freezing adult autologous stem cells it is important to prevent formation of large crystals in the cells which cause disruption of cell structure and possible cell death.  To avoid possible damage to cells, two precautions are taken:  the use of cyroprotective agents such as DMSO or glycerol and controlled rate of freezing.

Regenerative Sciences, which pioneered the Regenexx procedure has adopted the ICMS laboratory and clinical guidelines.  The quality of adult autologus mesenchymal stem cell therapy has now been elevated.

September 26, 2009

Elbow Pain: PRP and Prolotherpy

Pain localized on the outside of the elbow is referred to as tennis elbow or lateral epicondylitis.

elbow pain

A group of muscles called the extensors attach to the outside bony surface of the elbow.

extensors in forearm

Tendons attach  muscle to bone.  To better visualize this, image the rope that extends from your tent to the stake.  During a wind storm there is increased tension on the rope which starts to pull on the tent stake.  The greater the stress on the rope, the greater the force on the stake.  So to with increasing tightness in muscle:  there is more tension on the stake (tendon attachment to bone).  The result is PAIN.

Treatment at the Centeno-Schultz Clinic begins with a thorough evaluation and examination.  Prolotherapy and PRP are effective therapies to reduce the inflammation and irritation at the site where the extensor tendons attach to the bone.  Equally important is to treat the underlying cause:  the dysfunctional tight muscles, like the tent rope, which are straining its anchor.  This is treated with IMS. Treatment at the Centeno-Schultz Clinic includes treating the pain as well as addressing the underlying issue that gave rise to the pain.

September 24, 2009

Treatment of Sacroiliac Joint Pain with Prolotherapy

X-RAY IMAGE OF SI JOINTThe sacrolilac joint is the joint between the sacrum, the base of the spine, and the ilium of the pelvis.

It can be a common source of pain in patients who have had lumbar fusions and traumatic injuries.

Diagnosis is made by injection of a small amount of local anesthetic into the joint.  Insertion of a needle into the SI Joint can be challenging.  Confirmation of accurate placement is achieved through the injection of contrast which  fills the joint.  This is illustrated below with yellow dashed circle. 

Prolotherapy at the Centeno-Schultz Clinic involves injecting into joint as well as the surrounding ligaments.  A very important ligament for the  succesful treatment of the SI joint pain is the iliolumbar ligament.  The ligament is illustrated in blue.  It attaches to the L5 transverse process.

Maximal results from prolotherapy of the SI joint includes accurate placement of the injectate, as confirmed by contrast, as well as treatment of all ligaments.  This is the standard of care at the Centneo-Schultz Clinic.

September 22, 2009

The Bigger Picture

The American Stem Cell Therapy Association has opted for a global perspective.  Accordingly, it has changed its name to match its mission statement.

Coast Italy

 

The Internation Cellular Medicine Society was formed by physicians, scientists and other professionals to establish international laboratory and practice guidelines.  In addition,  there is a re-implantation registry that tracks all results and complications.

Mission statement:

-Produce guideline for the use of autologous adult stem cells.  (Autologous= a patients own cells).

-Provide standards for the minimal expansion of autologous adult stem cells (A-ASC).

  • -To educate physicians on cell based medicine and establish safe standards.

Regenerative Sciences, which provides the Regenexx procedure has adopted the guidelines set forth by ICMS.  In doing so, it has now provided an additional layer of safety for its patients.  The standard of care autologous mesenchymal stem cell therapy has now been raised.

An international conference discussing the current guidelines and stem cell therapies is in Vegas this November.

Upcoming conference on stem cell therapy would be the first of its kind.

September 21, 2009

MRI and Knee Pain

Knee pain can be located on the inside (medial) or outside aspect of the joint (lateral).

Common causes of lateral knee pain include meniscal damage, cartilage defects or injury to the lateral collateral ligament.

Accurate diagnosis requires a thorough history and physical examination along with a review of the MRI.   Dependence solely upon MRI studies puts a patient at risk for mis-diagnosis and treatment failure.  At Centeno-Schultz Clinic and Regenerative Sciences this is the standard of care.  Please review a recent patient case report.  Try to identify the source of pain.

Patient underwent Regenexx procedure on the other knee.  After injection of autologous mesenchymal stem cells he had reduction in pain, improved meniscal structure and reduction in  bone swelling.

regennex.regenxx.stemmcell.stemncell.kneepain.centeno-schultclinic.

September 20, 2009

MRI of Lumbar Spine: Stem Cell Therapy

The lumbar disc functions as a shock absorber.  There is a lumbar disc between each lumbar vertebral body.

Slide1

Lumbar discs are compromised of a supportive side-wall called the annulus fibrous and the inner gel referred to as the nucleus pulposus.  With degeneration there is weakening of the side wall with bulging of the disc.  The disc itself also looses height and brightness.  On the MRI, the disc will be shorter and darker.

Slide2

To strengthen the side wall, patients can undergo the Regenexx  procedure where their own  mesenchymal stem cells are injected into the disc. This regenerative in design as opposed a    microdiscectomy where a “nip and tuck” is performed on disc protrusion.  This latter procedure disrupts the integrity of the disc and increases risk of degeneration and recurrent protrusion or herniation.

lumbar-disc8-regenexx1

On Left Note L5/S1 Protrusion which significantly resolved after Regenexx Therapy

September 19, 2009

Fountain of Youth

Ponce de Le’on sailed to Florida in search of the  legendary spring that reputedly restores youth.

The quest to offset the effects of aging is extensive.  Creams, herbs and diets are just a few of the therapies reported to keep us healthy and young.

Current research has provided more insight into the process of aging.  A recent study demonstrated that decreased muscle mass associated with aging was the result of reduced blood flow and a reduction in sensitivity to insulin.  Equally important was the fact that exercise 3 times a week reversed the loss of muscle mass .  So…..

Bicycling

Yoga picture

Surgery with postop rehabilitation, immobilization and partial weightbearing can exacerbate muscle wasting.  Regenexx is non-operative therapy for many common orthopedic complications.  Regenexx utilizes a patient’s own mesenchymal stem cells in an attempt to heal lumbar disc injuries, non-union fractures, osteoarthritis of the hip and ankle.

September 9, 2009

Stem Cell Therapy for Non-Union Fractures

Today I saw a patient back in clinic who was quite upset 9 months ago.  He had fallen and fractured his tibia and fibula which required a surgery invovling  placement of a rod and two screws.  Despite surgery and a bone stimulator, the fracture did not heal.  He was so upset at the prospect of undergoing another surgery where they had planned on removing the existing  hardware and re-breaking the bones in an effort to stimulate healing.  Fortunately the surgery was not needed.

The patient utilized his own stem cells through the Regenexx procedure to heal the fracture.  He is out of his wheelchari and has no leg pain.  Regenerative Sciences enable patients to utilize their own stem cells to heal a variety of orthopedic conditions.

Ed Weakly

September 8, 2009

Sex and Mesenchymal Stem Cells

Many factors play role a role in the healing process.    Mesenchymal stem cells have a repair function in bone, ligament, cartilage and intervertebral  discs.

In previous blogs, I have referenced medication interactions on mesehcnymal stem cell function.

Clinically there is often a difference among woman and men.

Strube et al, examined whether there was a gender difference in bone healing and  whether this process was associated with a difference in the total number of mesenchymal stem cells.    In this study,  females demonstrated compromised healing and radiographically delayed bone formation  when compared to males.  These differences were associated with a reduced number of mesenchymal stem cells which were postulated to be  the possible cause of poor bone healing.

Stem cell function, interactions with medications, gender and age related differences are areas of keen interest.  Regenexx, which utilizes a autologous mesenchymal stem cells for orthopedic applications, has an extensive data base tracking these variables.  This  database hopefully will continue to shed light on these critical factors.

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