What You Need to Know About Regenerative Medicine

What is regenerative medicine?

Regenerative medicine is an up-and-coming area of medical care focused on providing treatments that assist the body’s natural capacity to heal diseased and damaged tissues. It works by reducing inflammation and modulating our immune system. This approach stands in contrast to more conventional measures, which typically focus more on managing symptoms with pharmaceuticals, or attempting to repair tissue (or abate symptoms) with surgeries and surgical implants. Spine Technology and Rehabilitation has been using regenerative medicine to help patients suffering from joint, muscle, nerve, and spine conditions for more than a decade.

What are stem cells and what do stem cells do?

Your life literally depends upon stem cells. So, if you have heard about them or not, they are kind of a big deal. As you read this, stem cells are busy in every part of your body helping you to heal from everyday wear and tear or injury, and aiding in the process of regeneration, replacing old, diseased or injured tissue with fresh new cells. Think of stem cells as the body’s tool repair kit for restoring old or damaged tissue. Their two most essential properties are their capacity to replicate or renew and differentiate or change into a specific cell type, based on your needs.

The jarring truth behind these amazing, life sustaining cells is that their discovery resulted from two of the most lethal events in mankind’s history. The people exposed to nuclear fallout from atomic bombing in Hiroshima and Nagasaki during World War II (who did not immediately perish) suffered devastating health problems. These events lead researchers (searching for a cure) to discover stem cells.

The concept of applying stem cells to disease models has been around for well over a half a century in the form of stem cell transplants. Bone marrow or stem cell transplants have become a gold standard in both replacing cells damaged by chemotherapy, and to fight against some types of cancer or blood related diseases (i.e., lymphoma, leukemia, multiple myeloma, and neuroblastoma). Scientists and physicians are working on novel means to harness the healing capabilities of this powerful tool kit, toward combating a host of diseases (ranging from joint problems to heart disease).

Where do stem cells come from?

Stem cells are present throughout your body. In fact, there are stem cells coursing through your blood vessels right now. They can be harvested from many sites including bone marrow, adipose or fat tissue, as well as the umbilical cord and placenta.

The fat in your body is the most abundant source of mesenchymal stem cells. These cells can facilitate the growth and repair of injured tendons, cartilage, and ligaments. 

What conditions benefit from regenerative medicine?

Consider that regenerative medicine exploits our bodies innate capacity to aid the healing of diseased and injured tissue. Consequently, many conditions may benefit from stem cell science including:

• Arthritis
• Rotator cuff injuries
• Tendon tears
• Bursitis
• Ligament and meniscus tears
• Neck and Back pain
• Nerve pain
• TMJ or jaw pain

Regenerative medicine is also used to assist healing after sports injuries and surgeries.

How are stem cells given to patients?

Stem cells and other biological media can be administered by a variety of routes. Spine Technology and Rehabilitation advocates for site-specific and navigation-controlled injections, as this approach is supported by research and experience. Specifically, the injection of stem cells into the injured area is guided by imaging devices, (such as ultrasound or fluoroscopy) – ensuring against procedural misadventure. Other routes of administration have included surgically implanted tissue, IV (intravenous) and intrathecal (in the spinal fluid filled sac) injections.

What are the types of regenerative medicine treatments and what can I expect during regenerative medicine treatments?

Regenerative medicine at Spine Technology and Rehabilitation (like most surgical centers or clinics) is conducted on an outpatient basis. The treatments vary in duration from 30 minutes to 1.5 hours.

• PRP (platelet rich plasma) Therapy – When you are injured your body uses the healing properties in your blood to stop the bleeding and repair the damage. These healing properties include platelets, growth factors, and specialized proteins. The PRP is processed from a sample of your own blood, and then injected  (with   generous amounts of local anesthesia) under navigation control directly to the site of injury or damage.

• Bone Marrow Therapy – Bone marrow is the spongy tissue contained within the hard outer walls of our bones. This spongy substance is crucial to life as it manufactures platelets, white blood cells and red blood cells. Manufacturing begins with a stem cell. The stem cells in your bone marrow are capable of morphing into other cells, including blood cells, connective tissue, bone and cartilage; depending on your body’s needs. Stem cells are also known for their capacity to replicate on demand.The procedure used to harvest and process bone marrow is done as a same-day outpatient procedure. With the use of conscious sedation and generous amounts of local anesthesia, a needle is guided into the rear hip bone. 30 to 60 mL of bone marrow is extracted with a syringe. The marrow is then processed to separate and withdraw the concentrated stem cell portion. Once the healing tissue has been derived, it is injected into your injured area with navigation instrumentation. There are no surgical incisions, only skin puncture(s) from the needle entry site(s). The back of the hip may be sore for a few days, as if you bruised it. Most often the pain responds to ice and Tylenol.

• Adipose Derived Stem Cells (ADSC) or Fat Graft Transfer Therapy – Fat from our body is the richest source of adult mesenchymal stem cells (MSCs).  These are your body’s own stem cells and have nothing to do with embryos or embryonic research. MSCs secrete multiple, powerful anti-inflammatory factors that inhibit the inflammatory process and modulate the immune response, optimizing the healing process. As a bountiful source of naturally occurring regenerative elements, our body’s fat turns out to be much more important than simply providing a cushioning effect to protect our organs. The procedure used to harvest and process stem cells containing fat is done as a same-day outpatient procedure. Adipose derived stem cells or fat grafts are obtained through a process similar to a liposuction procedure for plastic surgery.  This procedure is conducted with the aid of conscious sedation (an IV tranquilizer) and generous amounts of local anesthesia. Local anesthesia is delivered under the skin and in the fat tissue in the lower abdomen (immediately below your belly button).  Two tiny incisions are then made to pass probes (connected to suction) which are designed to extract fat. The incisions do not require sutures, only steri-strips. Once enough fat tissue has been extracted from the anesthetized (numbed up) area, the fat is placed in a specialized test tube and then processed employing a centrifuge technique.  The layer of fat cells containing your body’s stem cells are then extracted. Finally, the fat then undergoes an emulsification process. 

How long does it take to get results from regenerative medicine?

Some patients may experience an increase in discomfort for up to 10 days after their regenerative medicine treatments. That is because the first stage of healing is an inflammatory phase. For most patients their inflammatory discomfort eases within a few days. Many patients notice a considerable improvement in symptoms and function within a few weeks. Optimal results usually take 6-8 weeks to evolve.

Each patient’s course and response to treatment is individualized and dependent on many factors, including (but not limited to):

• their immune system
• overall health status
• lifestyle
• severity of injury
• compliance with treatment programs

Our experience at Spine Technology and Rehabilitation suggests that patients with the best outcomes are generally those with positive attitudes, healthy lifestyles, and most dedicated to the rehabilitation process.

How many treatments do patients require?

Many patients need only one regenerative medicine treatment to enjoy substantial relief of pain and return of function. Other patients require three treatments to gain the maximum benefit. The number of treatments should be tailored to the patient’s individual presentation, which includes factors such as the severity of their condition, their overall health, progress from both a functional and pain management perspective, physical demands of their activities of daily living (including work tasks and sports activities) as well as lifestyle considerations (e. g. nutritional status and pre-injury fitness). Your physician and healthcare team may suggest additional treatments based on your diagnosis, recovery profile and personal health needs. They need to remain in close communication with you throughout the recovery process to make the best treatment decisions and to help you guard against re-injury.

Does rehabilitation or physical therapy play a role in regenerative medicine or stem cell treatment?

If you are seeking to enjoy optimal benefits from regenerative medicine or stem cells for a musculoskeletal condition, the rehabilitation process is particularly important for you. Consider that bone, cartilage, and connective tissue proliferate and are configured according to loading behavior. Mesenchymal stem cells are generally the stem cell of choice for musculoskeletal conditions, because of their pivotal role in muscle, bone, joint, ligament and tendon healing. Consequently, a rehabilitation process geared toward proper loading of joints, muscles and connective tissue is arguably paramount to your recovery. Your physician and physical therapist will orchestrate this process through a systematic process of: postural realignment, muscle balancing and flexibility, movement patterning and graduated return to activities. To no surprise, Spine Technology and Rehabilitation has found that (as a rule) the patients with the best outcomes are the ones that are the most compliant with their rehabilitation protocols. To a good extent the adage: You get out of it, what you put into it, applies.

How much do stem cell treatments cost?

Prices vary wildly from one practice to the next and from one region to another. One practice may charge a few thousand dollars, while another demands tens of thousands of dollars.

Besides cost, what are some of the other factors to consider when choosing a regenerative medicine physician?

Spine Technology and Rehabilitation urges you to consider not only cost (to avoid cost gouging), but also:

• experience
• reputation
• How much time, care, and effort the doctor and staff devote to evaluating you and explaining their treatment approach to your condition
• State of the art equipment including navigation instrumentation, such as fluoroscopy and ultrasound.

What does the future hold for regenerative medicine?

Scientists and physicians are working on novel means to harness the healing capabilities of this powerful tool kit, toward combating a host of diseases (ranging from joint problems to heart disease).

Researchers are closing in on how to treat patients with their own stem cells, as well as banked genetically-matched donor stem cells. Imagine helping patients with diabetes regulate their disease by replacing their damaged pancreatic tissue with healthy insulin producing cells, or repairing the wounded heart muscle in a heart attack victim with new cardiac muscle cells. This is the long term promise of the rapidly growing medical specialty known as regenerative medicine.

Regenerative medicine may also usher in a new era of organ donation as researchers and scientists unlock the secrets of cultivating disease and defect free, organ-specific cells, which are capable of thriving in a host patient. — A comforting thought for the tens of thousands of individuals awaiting a donor organ.

To learn more about regenerative medicine and how it can help you heal, call Spine Technology and Rehabilitation today or schedule an appointment online.