Epidural Steroid Injection Alternative? Resolution of a Large Disc Bulge with PL-Disc/DDD
POSTED ON 5/23/2013 IN Research BY Christopher Centeno
Is the Regenexx-DDD procedure a lumbar epidural steroid injection alternative? OHA was a 29 year old who had failed a lumbar discectomy surgery and when seen last summer, had a 1.5 year history of recurrent low back and leg pain. His MRI at that time showed an impressive and very large central L4-L5 disc herniation. He didn't want Epidural Steroid Injections, so Dr. Schultz performed three Regenexx-DDD procedures (injecting his own growth factors epidural plus injecting his lax ligaments with the same growth factors). Above is his MRI from before the procedure and after his second procedure (but before his third). Note that the very large disc herniation (red dashed circle) has resolved (yellow dashed circle). Did the DDD procedure help this disc? You could make an argument that the disc herniation resolved on it's own. However, the fact that he had a 1.5 year history of unresolved back problems before the procedure would argue against that, as most of these studies show resolution in 1-2 years after the onset of the problem. In addition, after the procedures (and not before), his pain went way down and his function went way up. If the procedure did heal the disc, it may be due to the nature of a herniated disc (the inner part of the disc is pushed out through the outer annular disc fibers). We do know that herniated disc material can be cleaned up by the body and that increasing blood flow is a logical mechanism for facilitating this process. We also know that based on our own lab studies that the type of platelet lysate he was injected with has very high levels of VEGF, a growth factor that can build new blood vessels. The upshot? This was an impressive change in an MRI in a young man with a very large central disc herniation. OHA is still doing very well almost a year out from his first MRI (he was seen in clinic this week) and we wish him many more years avoiding the back surgeon's knife!
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