Pictures Dont Tell the Whole Story

Unfortunately there is large emphasis placed on MRI’s in the diagnosis and treatment of pain.

Radiographic studies are diagnostic tools which can assist in identifying a given patient’s pain when utilized in conjunction with a complete history and physical examination.  When viewed alone, MRI’s do not tell the whole story.

Consider the following:

Englund et al, in the New England Journal of Medicine, reported that 60% of patients with knee meniscus tears on MRI had no pain symptoms.

Matsumoto et al examined 497 patients WITHOUT pain and found the prevalence of degenerative disc disease to increase with age:  varied from 15% in patients who were in there 20’s to 86% in patients older than 60 years of age.

Jensen et al., conducted MRI’s of the lumbar spin in 98 patients WITHOUT back pain.  52% of the asymptomatic patients had a disc bulge.  MRI’s of the lumbar spine in patients WITHOUT back pain were normal in only 36%.

Diagnostic radiographic studies alone can not determine the source of a patient’s pain.  At the Centeno-Schultz Clinic we are committed to finding the source of a given patients pain by completing a thorough physical examination, history and review of radiographic studies.  Anything less is simply incomplete.

PRP Therapy for Lumbar Disc Protrusion

The  lumbar disc is composed of two principal parts: the inner jelly(nucleus pulposis) and the outer side wall(annulus).  The annulus provides support similar to that of the side wall of your tire.  If the side wall (annulus) becomes weakened, it can bow out.  When this occurs it is referred to as a disc protrusion, herniation or extrusion depending upon how far it protrudes  outwardly.  The protruding disc can be painful itself or it can press upon a nerve root causing leg pain.

Steroid injections have been use for lumbar disc protrusions however there is concern over the side-effects of high dose steroids as  previously discussed.

PRP injections are rich in platelet derived growth factors which have the potential of  increasing blood flow and therefore healing of the disc.

 The Centeno-Schultz utilizes various types of PRP to treat lumbar disc disease.   Examples  include platelet poor plasma, plasma lysate and activated PRP.  Patient specific platelet rich plasma injections created in a state of the art lab as opposed to those created by portable centrifuge units   are just another example of how theCenteno-Schultz Clinic distinguishes itself.

Understanding Your Lumbar Spine MRI

The lumbar spine is compromised of several principal elements:  the vertebral bodies, discs, spinal cord and spinal fluid.

All these structures can be identified on a schematic as well as an MRI of the spine.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 The vertebral bodies are the building blocks of the spine. There are 5 lumbar vertebral bodies

The disc is a shock absorber that is positioned between each disc.  A normal disc is contains water and therefore is bright white in color on certain types of MRI images (T2 images).

The spinal cord is a long thin bundle of nervous tissue that conducts information from the brain to the peripheral nervous system.

The spinal fluid bathes the spinal cord in fluid.

Injury to the disc can result in disc protrusions, tears in the outer fibers of the disc, reduction in disc height and pain.  At the Centeno-Schultz Clinic it is our goal to identify the source of a patient’s pain.  Regenerative therapies include prolotherapy, PRP and injection of autologous mesenchymal stem cells utilizing the Regenexx procedure.

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.

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.

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.

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