New Before/After MRI Images: Stem Cell Disc Bulge Treatment
POSTED ON IN Spine BY Christopher Centeno
I've blogged a few times on patient JS. I've been treating him on/off for 16 years for various problems. This week I'm treating him at our licensed site in Grand Cayman. About eight years ago, I treated his L5–S1 disc with specially cultured stem cells. A little more than two years ago, I treated his L3–L4 disc, which I'd like to do some show-and-tell on today. At the time, he was having left L3 nerve symptoms down into his thigh; hence, we focused on a disc bulge at that level with our stem cell disc bulge treatment. Now that he's back for a tune-up on L5–S1, I got a chance to sit down and place his L3–L4 disc films side by side.
Our Licensed Advanced-Practice Site in Grand Cayman
For years, we have allowed a site in Grand Cayman to use our culture-expansion technology to grow stem cells for patients that need that advanced care. It's a beautiful place to visit, as evidenced by this image taken off our back porch: We developed the technology for our stem cell disc bulge treatment through years of experience. This procedure is now the subject of an FDA phase-2 trial. However, in Grand Cayman, it's considered the practice of medicine.
JS's L3–L4 Disc
JS had a left lateral disc bulge abutting his L3 nerve. Since the L3 nerve supplies the big quad muscle and the skin of the thigh, his pain and symptoms were in the left thigh. If you look at the image above, you can see the image to the far left, which represents the 2014 image before his 2015 procedure. Notice that I have blown up the images of the disc bulge and the nerve. I have also outlined the disc bulge in a red dashed line and outlined the nerve in a blue dashed line. Notice how there isn't much room between the two. Also notice the brighter area just to the left of the dashed red line, which represents a large tear in the disc. The two images on the right are the two-year post-treatment images which straddle the old area (an exact-match slice is not always possible with MRIs). Notice how the distance between the disc and the nerve, which shows up as an oval here, is greater, which means the disc has gotten smaller. Also notice that the larger bright area in the disc, representing the tear, is smaller, indicating less of a disc tear. His leg symptoms also promptly resolved after the treatment.
Why a Stem Cell Disc Bulge Treatment Instead of Surgery?
When a disc bulge is treated surgically, the offending bulge is cut out. The problem is that this is like trying to fix a bike tire bulge by sanding down the bulge and thus making the tire weaker. This is exactly what happens with a disc—the surgery just weakens the structure. This new stem cell disc bulge treatment involves a very precise fluoroscopically guided injection into the disc bulge area using stem cells that are cultured so that they can withstand the harsh environment of the disc. The goal is to heal the damaged fibers that allow the disc to bulge.
What's Next for JS?
JS had a disc bulge treated eight years ago at L5–S1, and now this disc has begun to cause symptoms again and has a small degenerative bulge. He had a great run with his first stem cell treatment there, as we were finally able to manage his issues with an occasional platelet lysate epidural rather than being unable to keep his symptoms under control. Given that we were the first clinic on earth to inject stem cells into discs, we have patients with very long-term follow-ups who we can use to define how long the effects of these procedures last. Hence, he will get a tune-up disc injection while he's here in Grand Cayman. The upshot? It never ceases to amaze me how a precise injection of advanced stem cells can get rid of disc bulges in many patients. While this is not magic, it's certainly cool to see! The Regenexx-C procedure is not approved by the US FDA and is only offered in countries via license where culture-expanded autologous cells are permitted via local regulations.
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