80-year-old Georgia was suffering from back pain for many years. She also has many severe medical conditions including heart failure, pulmonary hypertension, and kidney failure. She is on dialysis.
Her MRI revealed disc degeneration, disc bulges, severe facet joint arthritis, and spinal stenosis.
She tried numerous treatments for her back pain including opioids, physical therapy, multiple epidural injections, burning off her facet joint nerves. Unfortunately, they did not help her. Because of her severe medical conditions, surgery was not an option.
She decided to get stem cell therapy. We extracted stem cells from her bone marrow and concentrated them. These cells were placed precisely into her discs, facet joints and sacroiliac joints using x-ray guidance. Below is the image of her procedure. Notice how her discs are collapsed and almost bone on bone, especially the L45 disc.
Since this procedure can be done with mild sedation and local anesthesia, in spite of her multiple medical problems, she tolerated the therapy very well.
Now she is almost pain-free.
See what Georgia has to say in the video below.
The common myth is that as we age, the number of bone marrow stem cells dramatically decline in the bone marrow. This is true for the bone marrow stem cells in the long bones. Fortunately, the stem cell numbers are much better preserved in the iliac crest bone [bone in the back of the hip] from where we obtain the cells. This is the main reason why we are seeing good results with bone marrow stem cells even in our elderly patients. Georgia is not an exception.
In fact, Georgia’s bone marrow cell numbers were very high. Her TNC [Total Nucleated Cell Count] was 1.87 billion. TNC is a surrogate marker for stem cell numbers. In one intradiscal stem cell study, the average TNC was 847 million. Georgia’s TNC was more than double of what was reported in that study. Age did not affect Georgia’s bone marrow stem cell count.
Dr.Hernigou is an orthopedic surgeon from France. He is the pioneer of stem cells for treating joint pains. He has been using bone marrow stem cells to treat pain for more than 40 years. Through his work, we now know that bone marrow stem cells are not only effective to treat pain but are also very safe. Other stem cells like fat, umbilical or amniotic stem cells do not have this long history of safety and efficacy. I borrowed a slide from one of his talks which explains why bone marrow stem cells work in the elderly.
One of his studies measured the number of stem cells as we age in both long bones and the iliac crest. The red line shows that as we get older, the number of bone marrow stem cell dramatically decline in the long bones. However, the blue line reveals that the numbers are relatively well maintained in the iliac crest where we get our stem cells from. This explains the good results that we are seeing in elderly patients.
This concept was also proven in another study. Here they analyzed the number of stem cells in the iliac crests of patients between the age of 26 and 83. Interestingly, they found a small decrease in the number of stem cells in older patients when compared to younger patients and this decrease was not significant.
We now have 2 studies that have shown that iliac crest bone marrow stem cells do not decrease with aging.
There are 2 types of bone marrow. The red marrow and yellow marrow. Red marrow is seen in younger patients. This red marrow is responsible for creating new blood cells. As we age, the red marrow becomes yellow marrow. This is because the red marrow is replaced by fatty tissue. Yellow marrow is not as efficient in producing new blood cells. However, this conversion of red marrow to yellow marrow happens only in the long bones. It does not happen in the iliac crest where bone marrow stem cells are extracted for stem cell therapy. See the picture below.
This is great news for patients because, among all the available stem cells, bone marrow stem cells are the most FDA compliant.
Since bone marrow stem cells are taken from the patient’s own body, there is no risk of allergic reactions or the risk of rejection.
Umbilical or Amniotic stem cells are obtained from other patients. This increases the risk of allergic reactions and rejection. Additionally, there is also an increase in the risk of transmission of viral and bacterial diseases from the donor. There have been reports of serious infections in patients who received umbilical stem cells.
A recent case that gathered a lot of media attention revealed that when stem cells are given from a donor, the recipient’s genetic makeup is altered. This is worrisome.
To summarise, currently, bone marrow stem cells seem to be the best for the following reasons.
They seem to be the most FDA compliant
They have the longest record of safety
They have the longest record of efficacy
They have no risk of allergic reactions or rejection
They have no risk of genetic alteration
If you are exploring the option of stem cell therapy to treat pain, insist on getting bone marrow stem cells. If the clinic is offering umbilical or amniotic stem cells, avoid it. These procedures are unfortunately expensive as insurance does not cover them. Spend your money wisely. After all, it’s your health.
Dr. Sairam Atluri is a pioneer of stem cell therapy in the Cincinnati area. He is one of the very few in the country performing intra-discal and subchondral injections to treat back pain and joint pain. He gives national talks and teaches other physicians about stem cell therapy. He is also a co-editor of one of the largest textbooks about regenerative medicine. Dr. Atluri is part of the team which wrote the ASIPP guidelines for stem cells to treat back pain. He is one of the few in the area to be certified in Regenerative Medicine by American Society of Interventional Pain Physicians [ASIPP].