Regenexx was featured in the Broomfield Enterprise . Click here for full article.
February 21, 2010
February 10, 2010
Theraupatic Lumbar Discogram?
Lumbar discography is procedure in which a needle is placed into the disc at two or more levels to determine whether of not a specific disc is the source of pain. Is the pain coming from the L4/5 disc or the L5/S1 disc? The procedure is performed with intermittent x-ray. Once the needles are in the center of each disc, contrast is injected into the disc. A patient’s response is graded as follows:
P0: no pain: a common response in a healthy disc
P1: painful, but not identical in quality or location to the patient’s daily pain.
P2: painful, identical in character, quality and location.
Discograms are strictly a pre-surigcal procedure which tells the surgeon which level to operate. They have no therapeutic benefit. I have had two discograms and they HURT!
A recent study demonstrated that lumbar discograms accelerate disc degneration.
Patients are often misinformed about discograms.
AJ was a 23y/o with 6 month history of low back pain following a rear-end motor vehicle injury. Pain was constant in duration, 6/10 in severity, progressive in nature and localized in her lower back, right =left with radiations into her buttocks. MRI was significant for mild degeneration of the L5/S1 disc. Physical examination was significant for tenderness in the lower lumbar spine with extension and rotation. She had no treatment to date: no physical therapy, chiropractic care, trial of good quality fish oil, massage or evaluation by a pain specialist. Her PCP referred her to a surgeon for evaluation of her back pain. She was scheduled for a discogram which she thought was going to help here back pain.
Evaluation of all possible sources of pain is essential. For lumbar back pain common causes include:
myofascial: dysfunctional muscles
ligamental dysfunction: treated with proloterhapy
SI joint dysfunction:
Disc dysfunction.
The Centeno-Schultz Clinic is committed to identifying the cause of a patient’s pain and designing an proper treatment plan utilizing state of the art therapies.
February 4, 2010
Normal MRI: No therapy Indicated
NG is a 34 y/o patient who presented with a 5 year history of left knee pain which was constant in duration, 3/10 in severity, progressive in nature localized principally at the knee cap and deep within the joint. Her large German Shepard ran into her left knee 5 year earlier which resulted in onset of severe pain. Treatment included physical therapy, E-stimulation, steroid injections and one surgery( lateral release). Surgery unfortunately increased her pain and frustration. Postoperative MRI of the left knee was normal . NG was informed that no more therapy was indicated.
Physical examination was significant for tenderness along the patellar tendon, slight limp, muscle tightness in her lumbar spine and tenderness and pain with palpation of her sacro-illace jont. Most significant however was the instability of her knee which her husband noted from across the room. The anterior cruciate ligamant(ACL),was very loose suggestive of a tear. Review of the MRI demonstrated a chronic tear in the ACL.
The anterior cruciate ligament is one of four major ligaments in the knee. It originates from the back portion of the thigh bone( femur) and attaches to the front portion of the shin bone ( tibia). It prevents forward movement of the tibia in relation to the femur. It provides critical stability to the knee. Tears of injury to the ACL result in instability of the joint with resultant pain.
There is no substitute for a complete physical examination. MRI’s alone can not make a diagnosis. Putting the physical findings together with MRI results is the standard of care at The Centeno-Schultz Clinic.
Utilizing a patient’s own stem cells, repair of a partial tear of the ACL is possible. The Regenexx procedure affords patients the opportunity to use their own mesenchymal stem cells to treat common orthopedic conditions.
February 1, 2010
Is there a Cancer Risk with Stem Cell Therapy?
Mesenchymal stem cells can differentiate into many types of tissue including muscle, bone, cartilage and tendon.
Because mesnechymal stem cells are multipotent, there has been concern that implanted stem cells could form cancer cells.
Studies have demonstrated chromosomal abnormalities in mesenchymal stem cells that have been cultured for extended periods of time. Other studies have demonstrated that mesnenchymal stem cells expanded for less than 60 days poses no detectable risk of cell changes or cancer formation.
The critical question is whether mesenchymal stem cells are safe ?
Centeno et. a.l. have shown that they are safe.
Centeno, in a prospective study examined 227 patients and found no evidence of cancer formation at re-implantation site. This finding is consistent with others who failed to find any evidence of cancer formation in mesenchymal stem cells culture expanded for limited periods.
Landmark study. Stem cell therapy has a green light!
SAFE TO PROCEED
The Regenexx procedure utilizes minimally expanded autologous meenschymal stem cells to treat common orthopedic conditions. This affords patients a non-surgical option with no extensive rehabilitation or the risks associated with anesthesia and surgery.
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