Is it Possible to Regenerate Nerves via Hydro-dissection and the Regenexx-PL Procedure?

By Chris Centeno, MD /

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regenerate nerves via hydro-dissection

We’ve been very cautious around nerves for obvious reasons. We haven’t used traditional stem cells around nerve injuries because of our concern that getting stem cells to differentiate into nerve cells is much tougher than for traditional orthopedic applications. Instead, we’ve focused on using our proprietary platelet lysate technology to help patients with irritated spinal nerves from herniated and bulging low back discs. This procedure avoids using bloody platelet rich plasma that might cause too much swelling around nerves and instead focuses on using a growth factor cocktail where the platelets are broken open in our lab to concentrate all of their cargo. We’ve had great success through the years helping patients get rid of sciatica by using their own natural growth factors and without using the toxic high dose steroids everyone else uses. But can we do more? Dr. Hanson had done some work in his last position using saline to break up scar tissue around nerves under ultrasound guidance. This is known as hydro-dissection. When he joined us he began to use platlet lysate because of our success with epidural injections. He noticed pretty remarkable effects in treating carpal tunnel syndrome and entraped ulnar nerves at the elbow. But can we do more? We recently treated a patient who regrettably had his femoral nerve injured with a nerve block while undergoing a knee replacement. He had tragically lost much of the strength in his qaudriceps muscle. 10 months into this nightmare, there was little hope of much nerve recovery. As a result we discussed with the patient whether he wanted to try the Regenexx PL procedure to attempt to regenerate nerves via hydro-dissection on the obviously constricted area of his femoral nerve as observed on ultrasound. He literally didn’t have much to lose. Two months after the procedure, here’s the phone message he just left:

“He was able to lift his leg when pre procedure he was not able to do leg lifts. He has been doing home exercises and lift the right leg, then the left leg and was amazed that he could do so. He did it again just to see if he could, which he was able to.  It has been aprox. 10 months without the ability to do leg lifts.  He does have a “aching pain” that comes and goes that is in the inner thigh it comes for an hour and disapates. At this time he doesn’t find it something that bothers him too much.  He just wanted to update that he could do leg lifts post-procedure.  New improvement!”

Is this possible? Could he be getting more motor function in the quadriceps muscle not only because the hydro-dissection released the scar tissue from the initial block injury, but also because we were able to grow new blood supply around the nerve? It’s known that the growth factors in platelets can regrow blood vessels and that nerves are surrounded by critical blood vessels that keep them healthy. Could the platelet lysate establish new and much needed nerve blood supply?  We’re cautiously optomistic about this one and will likely be pulling the trigger on a more formal study. The upshot? This could be very interesting in helping patients who have few good options…

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
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Shoulder

Shoulder

Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.

  • Rotator Cuff Tears and Tendinitis
  • Shoulder Instability
  • SLAP Tear / Labral Tears
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Cervical Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
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  • And more
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Knee

Knees

Knees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis.

  • Knee Meniscus Tears
  • Knee ACL Tears
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  • Knee Osteoarthritis
  • Other Knee Ligaments / Tendons & Overuse Injuries
  • And more
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Lower Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
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Hand & Wrist

Hand & Wrist

Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Hand and Wrist Arthritis
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb)
  • Other conditions that cause pain
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Elbow

Elbow

Most injuries of the elbow’s tendons and ligaments, as well as arthritis, can be treated non-surgically with regenerative procedures.

  • Golfer’s elbow & Tennis elbow
  • Arthritis
  • Ulnar collateral ligament wear (common in baseball pitchers)
  • And more
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Hip

Hip

Hip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures.

  • Labral Tear
  • Hip Arthritis
  • Hip Bursitis
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Foot & Ankle

Foot & Ankle

Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Ankle Arthritis
  • Plantar fasciitis
  • Ligament sprains or tears
  • Other conditions that cause pain
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