Friday, April 30, 2010

What happens if the stem cells don't work?



It's not about pessimism, but about being ready for the worst. There's a slight chance that my stem cell treatment won't regenerate my spinal disc and retract the herniation. I'm hoping it will though! It would come to show that stem cells are the next step in medicine. I still have another month and a half to see if it worked or not, but, in case it doesn't, i'm already preparing my next step: SURGERY.

The rule of thumb with doctors is that you have to try 6 months of conservative treatments/therapy before they consider you for surgery. Even after that, you have to decide between the different levels of invasiveness/effectiveness/recovery differences that all the options have. In my case, I'm going with the least invasive first, and if that doesn't work, with a more invasive procedure last. Here's a rundown of my treatment plan in chronological order:

1. Micro-Endoscopic Discectomy or Hydro-Endoscopic Discectomy: a minimally invasive procedure, outpatient, with a high success rate, but an equally high re-herniation rate. You're out of the hospital in an hour with only a band-aid, but the annulus (the outer wall of the disc) is damaged and weaken the disc, this leading to a re-herniation. It also does nothing to treat the degenerative aspect of the disc. Animation!
2. Another surgery like #1 in case of a re-herniation.
3. Artificial Disc Replacement: there are a few FDA approved devices in the US, but these are old compared to the devices that are being used and tested in Europe. I'm have my eyes on the Freedom Lumbar Disc by Axiomed. I would probably have this surgery performed in Europe, given that newer devices haven't finishes testing in the US. Animation and Video!
4. Fusion. They fuse your two vertebrae together to form one rigid structure. I want to avoid this at all costs! It's brutal!

Anyways, I'm hoping that the stem cell treatment will at least work to regenerate the disc and allow it to hold water again (this is why it shows black in an MRI, because it's no longer holding water). With this, I can at least assume that the disc is strengthened a little bit and that a micro-endoscopic discectomy will have a better probability of being successful.

Given this, I must add a new ingredient to the plan: PATIENCE. It's key to making the right decisions. A week ago, I was tempted to get surgery given a little flare-up in my sciatica pain. A few days later, it was gone and I'm optimistic again. This might not be the case with other people, but still, finding the right doctor and treatment is key.

Any thoughts?

2 comments:

  1. crap, I think I left my comments under the wrong post, anyway, in brief, I find the new motion preserving methods preferable to fusion should your decision come down to surgery and so long as you're a good candidate for ADR but there are so many variables which shape the outcome; as always, all we can do is arrive at the best humanly possible decision we can based on our own research, experiences and ability to process it all then move forward. I find there is no best move. There is no sure move. There are no guarantees. Fusion works better for some. ADR works better for some. All of which you know well.

    In my case, mid 30s, good facet joints, single level cervical, I've been deemed a good candidate for cervical ADR, however, I have concerns regarding the ball and socket designs, so I'm waiting for upcoming discs that better mimic real discs allowing for even vertical cushioning and absorption across the full diameter of disc. I think ball and socket designs, while allowing more flexion than fusion, miss a most fundamental function: vertical absorption.

    As I view it in my mind, a pivoting ball approach seems like a rock layered into a stack of mattresses if you will. That is, all the other discs/mattresses are cushioning vertical loads evenly, except one. So when weight load is applied to the spine the vertebral body above the ball and socket ADR pivots around the ball instead of being evenly, vertically cushioned like the rest of the discs in the spine. This motion, over time, seems it could wear the adjacent discs above and below the bacll and socket ADR prematurely, much like fusion; but that's just how I see it in my mind from an engineering perspective. So I'm waiting for artificial discs that work like real discs. Here's to hoping and best of luck.

    Steven R.

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  2. Thank you for the wonderful post Steven. It's encouraging to see other people as concerned as I am, and it's even more exciting to see that there are others literate on the subject and making their own decisions. Doctors tend to be biased toward their own techniques and don't really consider your specific situations.

    I'm waiting until the end of the year to make my final decision. I know there is a wonderful doctor in the UK that used the freedom disc. Ranier emailed me and told me that they expect to have their disc available in select european hospitals by the end of the year.

    All in all, I'm still doing research, weighing my options, and hoping for the best!

    Thank you for taking the time to write that. I really appreciate it. Also, I'm glad i'm helping out with all this information.

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