The Regenexx procedure used to treat disc bulges.

Author: Regenexx

Hi. My name is Chris Centeno. I'm the Medical Director for Regenerative Sciences, also medical doctor and stem cell researcher. I'd like to talk to you today about using adult stem cells to repair disc bulges. First, we have to really understand the structure of the disc in the low back. So basically, the disc has a tough outer covering, or the annulus fibrosus. You can see it there as A-N-A-L-U-S. It's a little bit of a misspelling.

A gel-filled inner center called the nucleus-- so this is the tough outer covering, the gel-filled inner center. And so the disc is basically a shock absorber made up of those two things. How do you get a disc bulge? Well, you can see on the left there the normal disc with an intact outer covering and the red inner gel, and then the disc bulge on the right, where the outer covering gets damaged and the inner gel pushes out on the outer covering. So you can see there the disc bulge is nothing more than a damage to the outer covering of the disc. So how do we currently treat this type of problem with surgery? Well, what we do, believe it or not, is we go in-- not with a pair of scissors, obviously-- with some very fancy surgical equipment, and we cut off the back of the disc. Now that does a good job, usually, of relieving pressure on the nerve, because that disc bulge is usually putting pressure on a nerve. But it does a poor job of any type of preserved integrity for the disc.

As you can see there, now the disc is less strong and more likely to herniate, meaning that stuff on the inside-- the red stuff-- coming completely out. So that's a problem. Is there a problem with trimming this disc? And as we've just talked about, this really reduces the strength of the disc. And the disc doesn't heal up by itself.

So we're left with a much better chance of reherniation or with that inner gel actually squirting out of the disc at some point onto the nerve. What if we could rebuild the torn fibers of the outer disc? We've been working on this for a number of years and would like to share with you some results. In this particular procedure, we take the patient's own adult stem cells and inject those into the back of the disc. These are specially prepared stem cells. And basically what happens is that they differentiate into fibrous tissue and then seal up or heal that tear in the back of the disc.

The Regenexx procedure used to treat disc bulges.

So we're getting rid of the bulge by strengthening the disc, rather than getting rid of the bulge by destroying the integrity of the disc. So here's the case report of two patients. Both had disc bulges with good disc height remaining, meaning the discs were not herniated. These discs were causing pressure on exiting spinal nerves and causing numbness down the leg. And we harvested adult mesenchymal stem cells, which were grown in culture, to bigger numbers. Now these were their own stem cells, or what's called autologous. These were then injected back into the disc under expert guidance. So as you can see here, the before picture on the left of the first patient, that's a picture of their disc bulge.

You can see it pooching out there at L5-S1. And then on the right, after treatment, about five months after the procedure, that disc bulge has resolved. We've now initiated long-term follow-up on this patient.

And that has not returned. The second patient is actually a woman around 28 years old. And you can see here, on the left, the size of that L4-L5 disc bulge, meaning the back part here that's bulging out, or pooching out, and then the resolution of that about two months after the procedure, on the right. You can also see there are measurements of the spinal canal-- a 1-centimeter spinal canal on the left, and it increasing in size to 1.2 centimeters on the right. Again, what's interesting about that is that this was done without any type of surgery or any type of significant activity restriction. So thanks for watching.

For more information on this type of procedure, see regenexx.com. We're excited about this, because for the first time, we think we've changed the playing field with regard to disc injury tear. Rather than cutting off the back of the disc and making the disc more likely to herniate, we believe we can now actually rebuild the back of the disc instead. Thank you so much.

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