New Regenerative Medicine Solutions For Back Pain Sufferers
By: Dr. Robert E. Jacobson, MD
Neurosurgeon
When a patient is considering the use of biologic treatments such as Platelet Rich Plasma(PRP), Bone Marrow Aspirate (BMA), commonly called ‘Stem cells’ or mixtures with placental preparations for treatment, the amount needed and location of the injection depends on the part of the body treated. Research evidence shows that injected biologics have a mixture of multiple cellular growth factors that work by ‘boosting’ the body’s healing of the injured area through accelerated but very localized inflammation in the site injected ultimately leading to tissue healing. Soft tissue such as muscle, tendons, capsules of joints and parts of the intervertebral disc are the targets for this treatment.
The spine is different than larger joints such as the knee, shoulder or hip in several important ways. First, these are larger joints that are easier to localize and inject, have mainly tendons running within them that can partially or completely torn which is best suited for biologic treatments. Larger quantities of biologic material can be easily injected in these areas. However, in the spine there are 3 additional critical factors whether in the low back (lumbar) or neck (cervical). First, each vertebral segment includes an intervertebral disc as well as 2 small joints (facets) on each side at each level so in the spine this can degeneration frequently occurs in multiple joints. Second, the nerve roots are located between the disc and the joints and the spinal cord in the neck and nerve sac (dural sac) in the lumbar spine is important and then precise placement of the injection is critical and should be performed only by a specialist with spine training and not who does occasional injections in this area. Therefore, it is critical that the patient have up to date diagnostic films including plain X-rays and MRI scan and possibly a CT scan so the spine specialist can locate the exact site of the pathology and discuss with the patient whether it is local to one area or side or more general. Since it is the small spinal joints, their surrounding tissue and the intervertebral discs that are targeted, biologics are more effective before severe degeneration and bone overgrowth occurs which can be seen on these radiologic studies. Previous treatments like injections or surgery, and the patient’s response in the past should be reviewed. After reviewing the radiologic films and analyzing how the radiologic abnormalities relate to the patient’s symptoms, the doctor can advise the patient on the best treatment, plus reviewing all other options and specifically how injecting biologics fits in their overall treatment plan and can be effective if appropriate in their case.
The goal of the treatment is to both decrease pain and allow some resolution of the soft tissue swelling of the disc and joints. After treatment, the patient is given a short and long term treatment and follow-up plan of initial rest than graded physical therapy and strengthening to improve the abnormal spinal area.
For more information on the wide array of Regenerative Medicine treatments available, or to schedule a free evaluation with Dr. Jacobson, please call Stem Cell Miami at (305) 598-7777 or visit: www.stemcellmia.com
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