Stemcelldoc's Weblog

November 30, 2013

Another ACL Tear Successfully Treated With Stem Cells

The Centeno-Schultz Clinic has previously reported on the successful treatment of ACL tears with stem cell therapy.

Stem cell treatments are an alternative to traditional knee surgery.

S.D. is 38 y/o world-class extreme skier who sustained a complete tear of his ACL and declined surgery.  He underwent 5 prolotherapies in Mexico with minor improvement.

drake stephan

On 7.31.2013 S.D. underwent the Regenexx SD procedure where bone marrow derived cells were injected into the torn ACL.  Due to abnormal neurologic examination and history of intermittent lower back pain also underwent Regenexx PL-Disc where concentrated platelet growth factors were injected around the exiting spinal nerve roots and lumbar discs.

On 9.13.2013 S.D. underwent a booster injection with Regenexx cSCP  injected into the ACL under direct x-ray guidance.

A new MRI was recently performed approximately 4 months post stem cell therapy.

The pre and post treatment images are posted below.  The ACL is outlined in yellow.  Note that the ACL fibers are disorganized and loose in the pre treatment images whereas post treatment the ACL fibers are uniform and tightly organized.  This is consistent with his clinical progress as he reports a reduction in pain and increase in stability.  Muscle weakness remains an issue but is improving with MAT techniques.

Drake. ACL pre and post 2013.sagittal

Drake. ACL pre and post 2013.Coronal

Congratulations to SD who declined surgical repair and opted to utilize his own bone marrow stem cells to repair his torn ACL.  Updates to follow as snow continues to fall and the depth of the powder increases.

November 10, 2013

Suprascapular Nerve: A Key Player in Shoulder Function and Pain

At the Centeno-Schultz Clinic we understand shoulder pain.

Stem cell treatment is an alternative to traditional shoulder and rotator cuff surgery.

The suprascapular nerve is a key player in shoulder function and pain.

The suprascapular nerve is derived from upper trunk of brachial plexus typically C5 and C6.  It contains both motor and sensory components.  The sensory branches innervate the GH and AC joint whereas the motor branches innervates the supraspinatus and infraspinatus muscles

The suprascapular nerve runs lateral and beneath the trapezius and enters the supraspinous fossa through the suprascapular notch.  The suprascapular notch or referred to as the scapular notch is a notch in the superior border of the scapula through which the suprascapular nerve descends.  The supraspinous fossa is a concavity above the spine on the dorsal surface of the scapula that gives origin to the supraspinatus muscle.

supraspinus fossa

suprascapular nerve

MSK ultrasound is utilized to identify the nerve and any possible entrapment which can lead to pain and or weakness.

Suprascapular Nerve US. jpg

Sites of entrapment and clinical presentation will be discussed in future posts.

Ablation of the nerve utilizing radiofrequency has been described by Liliang as an effective treatment in the management of chronic shoulder pain.

Upshot:  the suprascapular nerve and its visualization is critical to the successful management of shoulder pain.

November 3, 2013

Iliolumbar Ligament: A Key Stabilizer of the lumbar spine

At the Centeno-Schultz Clinic stability is a central theme acknowledging that instability can lead to additional wear and tear, degeneration and injury.  To understand the importance of stability refer to  our e-book, Orthopedics 2.0

Stability is dependent upon 2 principal factors:  muscle strength and ligament integrity.

The iliolumbar ligament (ILL)I s an important stabilizer of the lumbar spine.  Ligaments are fibrous tissue that connect one or more bones together.  Think of them as duct tape.   The ILL originates from the lateral aspect of the transverse process of L4 and L5 and attaches to the anterior surface of the ilium (waist bone).  The ligament literally prevents the L5 vertebra from slipping forward.

iliolumbar ligament

Pool-Goudzwaard also demonstrated that it ILL was an important stabilizer of the SI joint.

The iliolumbar ligament can be injected under x-ray guidance or MSK ultrasound which is the standard of care at the Centeno-Schultz Clinic.  Below is an x-ray image from clinic with the ILL outlined.

The Regenexx-DDD procedure deals with both the lax ligaments and the irritated nerves without using harmful steroids.  The procedure involves platelet growth factors that are injected into the epidural space as well as into the lax ligaments.  Previous blogs have discussed clinical cases where patients have utilized their own platelet growth factors and avoided lumbar surgery.

iliolumbar ligament x-ray

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