Stem Cell Therapy
Painful discs in the neck or low back are common causes of severe back pain and disability. Historically, therapies did not exist to regenerate the degenerative process in a vertebral disc, often leaving surgical intervention as the only option if other non-operative treatment options have failed. In selected patients, we now have hopes of better ways to treat spinal disease. Regenerative therapies for the spine are the future for spinal treatments. We are excited to offer innovative techniques as new and improved ways to try to heal spinal problems without having to undergo surgery. Regenerative therapy options hold wonderful healing potential and represent the future of modern medicine.
In the United States alone, more than 400,000 lumbar discectomies and 500,000 spinal fusions are performed each year for symptoms related to lumbar disc degeneration. The ability to get these to heal without surgery has been a long-term goal of many patients and physicians alike. At Virginia Spine Institute, we are working to promote healing without surgery. Virginia Spine Institute continues to be on the forefront of treatment options and is proud to offer stem cell therapy treatments for patients as part of our comprehensive non-operative treatment options.
This is how it works
We obtain a patient’s own stem cells by aspirating tissue from the patient's hip bone or from their fat cells. These cells are centrifuged down to identify and separate specific primitive cells that will help heal tissues. Stem cells are then injected into the disc, stimulating healing of the disc by using these primitive blood cells to stimulate regeneration of the collagen within the disc. We are excited to report improvements in our patients treated with stem cells.
What are Stem Cells?
Stem cells are undifferentiated cells that have the potential to become specialized types of cells. Stem cells can be categorized as embryonic stem cells or adult stem cells. Embryonic stem cells are derived from a human fetus; there are many ethical concerns with embryonic stem cells, and these are not used in our practice.
Adult stem cells are derived from adults, sometimes obtained from your very own body! Adult stem cells are further divided into different categories. For example, the types of adult stem cells we use to treat musculoskeletal issues are known as mesenchymal stem cells (MSCs). These are multi-potent cells that can differentiate into bone cells, cartilage cells, or fat cells. It’s important to note that they cannot differentiate into any other type of cell.
How ARE mesenchymal stem cells (MSCs) Obtained?
The human body has multiple storage sites for stem cells to repair degenerated and injured structures. We have found that obtaining stem cells from the hip bone (iliac bone) is easily performed within minutes and, in most cases, is a fairly painless procedure for the patient. The stem cells are obtained from your own bone marrow; just minutes later, they are used for treatment.
This procedure is done in our office and starts with the patient lying face down on the examination table. The skin is first numbed with a novocaine solution. After that, the cortex of the hip bone (iliac bone) is numbed. Next, under x-ray (fluoroscopic) guidance, a special needle is advanced through the bone to the cortex of your hip bone into the bone marrow. The liquid marrow - which contains the stem cells - is then withdrawn into a syringe. Finally, the needle is removed, and a small bandage is placed where the needle was inserted.
After the procedure, the syringe of stem cells is taken to the lab and placed in a specialized machine called a centrifuge. The centrifuge spins the bone marrow solution and stem cells are separated from the non-useful cells. The concentrated stem cells are then transferred to a new syringe. Now, the stem cells are ready for the treatment.
What conditions might benefit from stem cell injections?
Not all patients will be a candidate for these disc regeneration procedures. For those whom are ideal candidates, this provides great hope with reduction in pain and improved quality of life without the need for major surgery. We are excited about these great advances in health care and look forward to helping you live pain free.
Stem cell injections are most commonly used for treatment of the following conditions:
- Osteoarthritis of the joints including knee, hip, shoulder, and ankle joints
- Chronic partial rotator cuff tears
- Persistent partial tendon tears, such as tennis elbow, plantar fasciitis, quadriceps and patellar tendon tears
- Muscular tears
- Meniscal (cartilage) tears in the knee
- Discogenic back pain
- Spinal facet pain
- Chronic radiculopathy (pinched nerve)
- Sacroiliac joint pain
How are the stem cells injected?
The area of injury is first identified using ultrasound or fluoroscopy. The area is then sterilized, and the skin above the area is numbed with a novocaine-type solution. Using ultrasound or fluoroscopic guidance, the needle is guided to the area of injury, and the stem cell solution is injected. All the regenerative injections performed at our practice are performed under image guidance with ultrasound or fluoroscopy to confirm accurate placement of the stem cells.
What are the risks of stem cell treatments?
The risks depend on the area being treated; however, there is always a potential risk of an injection causing infection, bleeding, or nerve damage. It is important to note that there is no risk of allergic reaction since you are using your own stem cells. At Virginia Spine Institute we always recommended the safest and most efficient procedures for our patients, however, your physician will review any possible risks associated with this treatment prior to administering.
When will I see benefit from the procedure?
The benefit is usually seen approximately two to three months after the whole treatment protocol has completed; however, you may start to notice the benefit sooner than this.
How many injections do I need?
In most cases, patients respond very well to just one treatment; however, the patient may require two to three injections. We never perform more than three injections within a span of 12 months.
FDA CLINICAL TRIAL STUDY
Virginia Spine Institute is part of an ongoing FDA clinical trial study and now also offers stem cell therapy to patients not enrolled in the study. This pioneering cell therapy, currently under investigation by our physicians, shows promise in restoring the structure of degenerating discs and alleviating pain after other non-operative treatments have failed.
The clinical trial uses NuQu (made by ISTO Technologies, Inc) to attempt to restore a damaged disc to save the disc and prevent further degeneration. NuQu is composed of culture-expanded juvenile cartilage cells (stem cells) in a protein-based carrier. These cells have been proven to have far greater regenerative potential than adult cartilage-forming cells based upon preliminary investigations.
After evaluating hundreds of patients for the FDA trial comparing these cartilage forming stem cells to a saline placebo, the spinal experts at Virginia Spine Institute were able to enroll 5 patients in the study. Although early results have been promising, the evaluation will not be complete until a full year passes after the injection.
Although NuQu is an early-stage, cell-based therapy aimed at treating the cause of back pain associated with degenerating discs, we remain optimistic that it has the potential to cure this disease. This pioneering cell therapy, currently under investigation by our physicians, shows promise in restoring the structure of degenerating discs and alleviating pain after other non-operative treatments have failed and before surgery even becomes a consideration.
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