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Long-term Follow-up on Injecting Stem Cells into a Disc

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JP is a 31 year old white female who had failed a laminectomy low back surgery several years before we began seeing her in 2007. She had back and leg pain that would only respond short-term to traditional steroid epidural injections. As a result, she was entered into one of our studies. In 2007 we injected two discs with her own stem cells, L4-L5 and L5-S1 (where she had her laminectomy). I recently followed up with her and she’s doing well, although there is suspiscion that the untreated L3-L4 disc is starting to further degenerate and cause symptoms. The images above are looking down on the cross section of her low back and show a before and after 3.0 T MRI image of the L5-S1 disc (before on the left and after on the right). The top images have been left without annotation, while the bottom images have been annotated with the back of the disc outlined in a dashed white line and the S1 nerve represented by the yellow dot. You can see that her L5-S1 disc is pushing out to the right (MRI left right is backwards, this is represented in the picture above by the disc pushing out to the left of the screen). Notice that this disc bulge (red arrow) is very close to the S1 nerve (yellow dot). When that happens, the patient gets numbness, tingling, and often weakness down the leg into the little toe, sole of the foot/heel, and calf. You can see in the after MRI that her disc bulge is much better and now there’s distance between the back of the bulge (dotted line and the yellow dot-S1 nerve). So the good news is that these results are holding up long term at the L5-S1 level. The treated L4-L5 disc is also similarly still improved. The untreated L3-L4 disc is the same or slightly worse, indicating that in this woman, a disc bulge left untreated doesn’t get better on it’s own.

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