Regenexx (Adult Stem Cell Therapy for Degenerative Disc Disease)

[sportsnut3007]

I am considering going to regenexx to get stem cells for a possible bulging disc in my lower back. Does anybody have any insight on cancer risks with adult stem cells? Anybody been there or know anything about the Dr Centrino i think is his name? Anybody know if such stemcells repair last for life? I read something before about how stem cells they use in europe to inject back in the disc to help generate more nucleus material only last a few years or something of that nature. The guy seems top notch and says on his site that adult stem cells culture for short term doesnt show signs of cancer. Im afraid of the whole stem cell thing period, but would prefer I guess to risk it instead of just getting some nucleus material sucked out in a nucleoplasty procedure. Also, does anybody know the effects long term of having nucleoplasty where they use a needle/wand to evaporate some nuclear material? I would guess this would degenerate the anulus faster. I figure the more nuclear material I can keep, the better!!!

[KBear]

I wish I could help you out on this one; but I have no idea.

[Cindylou]

Lots of good questions. I am in the dark also on this one, but others will chime in soon. Good luck!

[Justin]

***EDITED: 12/7/09 to help clarify cancer risk addressed by Dr. Centeno in his post below.

I am considering going to regenexx to get stem cells for a possible bulging disc in my lower back. Does anybody have any insight on cancer risks with adult stem cells? Anybody been there or know anything about the Dr Centrino i think is his name?

Hi SN,

I'm sure you have seen the following information on the Regenexx website, but I am posting here just in case you haven't: The Regenexx™ Procedure - alternative to traditional joint and bone surgery (Adult Stem Cell Therapy). Personally, I have not heard much about Dr. Centeno.

This is a great introductory read about stem cells from the National Institutes of Health: Are Stem Cells Involved in Cancer? ***Please see Dr. Centeno's post below.***

Anybody know if such stemcells repair last for life? I read something before about how stem cells they use in europe to inject back in the disc to help generate more nucleus material only last a few years or something of that nature. The guy seems top notch and says on his site that adult stem cells culture for short term doesnt show signs of cancer. Im afraid of the whole stem cell thing period, but would prefer I guess to risk it instead of just getting some nucleus material sucked out in a nucleoplasty procedure.

In regard to your questions above, the National Institutes of Health Stem Cell Informational website is a great resource. See this website: The National Institutes of Health resource for stem cell research. They also have a very informative page that has answers to Frequently Asked Questions.

Also, does anybody know the effects long term of having nucleoplasty where they use a needle/wand to evaporate some nuclear material? I would guess this would degenerate the anulus faster. I figure the more nuclear material I can keep, the better!!!

Here's a previous discussion (with links to literature on nucleoplasty): Automated Percutaneous Lumbar Discectomy for the Contained Herniated Lumbar Disc: A Systematic Assessment of Evidence

I hope this helps.

[Dr. Centeno]

Dear all,

This is Dr. Centeno, the developer of the Regenexx Disc procedure. I was asked by a colleague to respond to these posts, as this is a complex area and it helps to make sure everyone is informed. The cancer risk currently in the news about stem cells, mainly concerns embryonic stem cells. These are stem cells built to make a whole person, so they do have known tumor risks. Adult mesenchymal stem cells (they type used in the Regenexx procedure) are built to repair things in your body, so they have no significant cancer risks in animal studies when they are cultured for minimal periods (as in the Regenexx Disc procedure). We just published the world's largest complications and safety study in stem cell therapy to date, located at http://www.ncbi.nlm.nih.gov/pubmed/19951252?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed _ResultsPanel.Pubmed_RVDocSum&ordinalpos=1

In this 3 year tracking period, we saw no evidence of cancer being caused by the cells. This doesn't absolutely rule out the risk of that something like this could occur, but if you look at the risks of low back surgery (fusion and/or laminectomy) and stack them up against our group of 227 patients, the risks of surgery would far outweigh any that were seen in our orthopedic applications. As an example, the serious complications rate for low back surgery is usually quoted in the 3-5% range, with some authors reporting complication rates as high as 40% for pedicle screw fusion. Applying those numbers to the 227 patients in this paper, would mean at a minimum of 7-12 patients with serious complications if the same group underwent low back surgery. This is much greater than the complication rates for orthopedic stem cell treatment delivered through a needle.

As far as the durability of the Regenexx disc procedure in patients that have responded, the long term outcomes are unknown. The oldest patients have only been tracked for the last 3-4 years. The major problem with all surgical disc approaches (nucleoplasty, laser spine surgery, discectomy, micro-discectomy, etc...) is that, in our opinion, removing tissue from the disc leads to more degenerative disc disease in the long run. If you use a bicycle tire analogy, our current state of the art is like trying to fix a bicycle tire failure with sandpaper. As an example, if you have a bike tire where the outer rubber casing is partially broken (in this case the outer annulus of the disc), the inner tube (in this case the nucleus pulposis or soft gel part of the inner disc) can cause the tire to have a bulge. We now fix that bulge by sanding down the outer rubber casing of the tire (removing pieces of the annulus) and thus weakening the structure. In the short run the bike will ride better, but the tire is now set up for structural failure down the road. We believe the Regenexx approach is akin to placing some glue in the tears and thus fixing the structure by healing the outer part of the disc. So in our opinion, cutting out pieces of this disc (no matter how carefully or minimally invasive), will eventually be replaced by a disc repair methodology.

Hope this helps!

Chris Centeno, M.D.

[Justin]

Welcome, Dr. Centeno!

Thank you for posting this information and for clarifying the role of adult stem cells--it is most appreciated!

Keep up the great, ground-breaking work.

[Keano16]

Dear Dr. Centeno,

you have same tought and methods as my spine surgeon. As he says "We must save and protect the disc".

Have you treated any patients with big annular tears and disruptions. To be more precise, have you tried injecting stem cells around the area of anulus where sinu-vertebral nerve endings are present?

[JK2234]

I wish it was this easy to re-grow the disc..

[Dr. Centeno]

Dear Dr. Centeno,

you have same tought and methods as my spine surgeon. As he says "We must save and protect the disc".

Have you treated any patients with big annular tears and disruptions. To be more precise, have you tried injecting stem cells around the area of anulus where sinu-vertebral nerve endings are present?

Yes, we have treated annular tears.

[Keano16]

Please provide me, and other members with some more information.

How you diagnosed annular tears, were they symptomatic, what was success rate?