Friday, January 15, 2010

Stem Cell Therapy with Regenexx - Update

Greetings everyone.

I had a terrific phone conversation with Dr. Schultz on Wednesday January 13th.

First he gave me his diagnosis, which was professionally done. He told me I lost some height on my disc and that the left-leaning bulge (note that it hasn't yet leaked out) he diagnosed was consistent with my intense left-side pain. He then went into explaining how candidacy for this type of treatment works:

**Good Candidate**
MRI imaging that shows single level disc degeneration
with disc height maintained at greater than 50%. Disc
protrusions and posterior longitudinal ligament are
intact. No previous lumbar spine surgery. Patient age is
less than 50 years with radicular symptoms that
correspond anatomically with disc pathology.
Transforaminal injections eliminated radicular pain.
These patients are in the same general category of
patients who have shown consistent pain/functional
changes with the Regenexx procedure.

**Fair Candidate**
MRI imaging shows one or more lumbar discs that are
degenerative in nature with disc height reduced by 50%
or more. Disc protrusions and posterior longitudinal
ligament are intact. No previous lumbar spine
surgeries. Radicular symptoms may not directly
correlate anatomically with disc pathology.
Transforaminal injections afforded only partial relief of
radicular pain. These patients may have a higher risk of
failure with Regenexx procedure to change their
pain/function.

**Poor Candidate**
MRI imaging shows multiple levels of disc degeneration,
disc height of affected levels reduced by move than
50% and protrusions are not contained. Reactive
endplate changes noted along with advanced reduction
in disc signal. History of prior lumbar surgery. Patient
age over 50 years. It is unlikely that the Regenexx
procedure will be helpful for this patient.

He sent me a report with this information after the conversation was done. I fell into the FAIR candidate category. He recommended I go ahead with the treatment given his past patient's success with this type of condition.

He says the first phase of the treatment involves a bone marrow extraction. The second visit involves them injecting me with a PTP (Platelet Rich Plasma). He says he wants to increase circulation and hydration in the disc using this (I assume this is so the stem cells work in an adequate environment). The third visit involves the actual injecting of stem cells into the damaged disc. This is repeated two more times for a total of 5 visits.


He Also Said: 

Negatives for me:
One of the negatives is that there is a herniation. Also, a high intensity zone, a tear in the outside fibers of the discs. I would put you in the 'Fair' because of the extent of the herniation or bulge. But I think you would do well.

Other comments:
Part of our therapy isn't only putting cells in your disc, but also some growth factors from platelets to attempt to increase the blood flow.

Do they have a chance of restoring the disc if it is diseased? 
Yes. Darkness on the MRI indicates that the proteins in the disc are not holding any water, so it is degenerative. The disc should turn white in the MRI, which means it is restoring its moisture. We've also had patients that have had reduction in their disc protrusion as well.

Any physical therapy alongside the treatment?
Well, NO WEIGH-LIFTING. Back strengthening and core stabilization is always useful. An inversion machine is great. You don't have to stand on your head with an inversion table. Just get used to lying parallel to the floor and teeter a little, 5 degrees. Don't engage your cord too much.. up to 10 or 15 degrees.. maybe take a nap on it if you're talented.









How have people been doing in general?
"people have done well. We continue to evolve our techniques, and I would say you have a good chance of reducing your back and leg pain."


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