Epidural Steroid Injection Reviews: Is There a Better Way?
POSTED ON 4/18/2016 IN Research BY Christopher Centeno
My patients' epidural steroid injection reviews through the years have been mixed. On the one hand, the injection can help prevent the need for surgery; on the other, the side effects can be big and awful. Hence, a few years back, we invented a new approach using platelet lysate to replace the steroid. This is the video I prepared from a talk on the topic I gave this past weekend at the American Academy of Orthopedic Medicine in Florida.
What Is an Epidural Steroid Injection?
An epidural steroid injection is a precise image-guided shot usually given to help an irritated nerve in the spine. The average patient receiving this injection is someone who has a herniated or bulging disc that's putting pressure on a nerve or intermittently irritating a nerve. They are also given to patients who have a leaky disc or a degenerated disc. The shot involves injecting high-dose steroids (about 1,000,000 times physiologic) into the area around the nerve (epidural space). The injection can be effective in helping reduce back and leg pain.
What's the Problem with High-Dose Steroids?
As the video shows above, the high-dose steroids injected can lead to issues. For example, one study showed dramatically increased bone loss in older women per shot. Others have shown everything from problems with blood sugar control due to impacts on cortisol levels to an increase in the rate of failed hip replacement due to infection. The bottom line is that the big steroid hit is not healthy.
Is There a Better Way?
Quite some time ago, we began substituting the high-dose steroids with platelet lysate, a natural growth-factor cocktail made from the patient's own blood by breaking open the platelets in PRP (platelet rich plasma). Through the years, we've tested this in different ways in our registry, including against the results of epidural steroids. What we found was better results when using platelet lysate. The video above goes into more details on the two different groups on which we've reported data (a comparison to epidural steroids and a much larger group of 662 patients).
Is There a Better Platelet Lysate?
We've also spent the resources in our state-of-the-art, on-site research facility to optimize platelet lysate and have created third- and fourth-generation versions of the process that maximize growth factor levels and cell response. As with anything we do at Regenexx, we're constantly studying whether or not we can improve the process. The upshot? When it comes to epidural steroid injection reviews, platelet lysate gets five stars. In addition, our third- and fourth-generation platelet lysate has revolutionized our practice and that of many of our network physicians. I'll never forget one Regenexx network doctor who came up to me at our national meeting last year. The doctor had been pretty skeptical that Regenexx could improve the tools he was already using, but he had been nudged into the network by his partner who understood the value. He looked me in the eye and said that as an interventional spine physician, no other tool that he had used in his career had revolutionized his patient care like platelet lysate. It was pretty gratifying to see this particular doc get turned around and for that 180 to help many more patients than I could have ever treated on my own!
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