Archive for the ‘Texas Back Institute’ Category

Administering undifferentiated stem cells to an injured disc has made adult stem cell regenerative medicine in spine a reality. Adult stem cell regenerative medicine holds the promise of stabilizing or even reversing the degenerative changes associated with aging or following traumatic injury. Current clinical use of stem cells is very limited, in part by the cumbersome approval process. The use of concentrated bone marrow aspirate (BMC) as a “stem cell” preparation is currently the simplest and safest way of utilizing the regenerative potential for mesenchymal stem cells (MSCs) to promote tissue regeneration. In fact, stem cells concentrated from bone marrow have been shown to stimulate the formation of bone, cartilage, ligament and tendon, and dermal tissues.

Conservative treatment options for lumbar and cervical pain associated with discogenic disc disease (Pfirrmann Grades 3-6) are limited. Treatment options include pain medication, steroids, physical therapy, and chiropractic care. Reversal of disc pathology has not been achieved with current available treatment modalities. Failure of these nonoperative treatments may leave surgical intervention as a treatment option.

The goal of utilizing MSCs is to not only potentially provide pain relief from the painful degenerative disc, but to reverse the degenerative process. There are three methods for placing MSCs into the painful nucleus pulposus.

The use of allogeneic mesenchymal precursor cells (MPCs) is currently being evaluated as a part of an FDA Phase I clinical trial. Extracted from donors and expanded in number by tissue culture, this process isolates and grows the stem cells into pure MPCs which are injected into the nucleus pulposus. This technology does not have FDA approval.

Utilizing expanded, autologous MSCs for injection into the painful disc is the second method. Federal regulations require the approval of an Investigational New Drug application supported by prospective, randomized clinical trials for the use of expanded autologous MSCs. The FDA has not approved this technology.

The third method involves autologous point of care therapy. This technology does not require FDA approval. The patient’s own MSCs are directly injected into the nucleus pulposus of the symptomatic degenerated disc(s) using standardized two needle discography technique. This requires fluoroscopic visualization and 2-3cc of MSCs are slowly injected into the symptomatic nucleus pulposus.

Early analysis of the research data reveals the average lumbar pre-treatment Oswestry Disability Index (ODI) was 56.5% and improved to 22.4% at three-month follow-up (P=0.0001). The average lumbar pre-treatment Visual Analogue Scale (VAS) for pain was 7.9 (on a scale of 1-10) and improved to 4.2 at three months (P=0.0005).

There have been no complications associated with the iliac crest aspiration or disc injection. Thus far no patient in the study has undergone spine surgery following treatment. Results obtained with this technique suggest its potential clinical efficacy in the treatment of moderate to severe degenerative disc disease. These results require verification with longer follow-up and randomized prospective studies.

For more information regarding treatment options please visit our websites at http://www.becomepainfree.com

Become Pain Free | Pain Specialist in Texas

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Written by becomepainfree

January 26, 2013 at 5:55 pm

Texas Back Institute, Texas Back Institute Trained Surgeon, Texas Back Institute Fellow, TBI, Texas Back Institute Spine Surgeon

Dr Saqib Siddiqui M.D.

BOARD ELIGIBLE ORTHOPEDIC and SPINE SURGEON Trained by the Texas Back Institute in Plano, Texas

https://www.becomepainfree.com/ Call Us: (214) 396-3647 | (888) 373-3720
Fax #: (888)238-9155 | E-mail Us

Dr Siddiqui is proficient in treating cervical, thoracic and lumbar spinal conditions and disorders whether they require surgical treatment or non-operative treatment. Degenerative disc disease is a common problem that afflicts many individuals. There are many state of the art procedures available today such as artificial disc replacement (or spinal arthroplasty), dynamic stabilization, interspinous distraction for spinal stenosis, as well as more traditional options such as spinal fusion, epidural spinal injections, rhizotomy, spinal cord stimulators, selective nerve root blocks, facet blocks and sacroliiac joint injections. Dr Siddiqui is able to treat most of his patients conservatively with physical therapy, braces, injections and pain medications. If you do require surgical treatment ,you will have access to the world’s most advanced techniques such as minimally invasive spine surgery. Dr Siddiqui was the first surgeon in Houston to perform the XLIF (extreme lateral interbody fusion) which is a technique enabling the surgeon to fuse the lumbar spine through a 2 inch incision from the side, often being done as an ambulatory procedure at a surgery center. Dr Siddiqui is also one of only a handful of surgeons in Houston performing trans-sacral L5/S1 fusion also through a 1 to 2 inch incision. Dr Siddiqui also performs percutaneous discectomy for patients with a herniated lumbar or cervical disc. Patients are able to leave the surgery center in only a couple of hours after a 30 minute procedure sporting just a bandaid and little of no recovery time.