One of the most common spine injections used to help prevent spine surgery is an epidural steroid injection. This procedure involves placing the medication “epidural”, which literally means on top of the dura (the dura is the covering of the spinal cord and nerve roots). Placing medication in this location helps to reduce swelling around the spinal nerve usually caused by a bulging or herniated disc. The main downside of this approach is that the medication that’s often used (high dose steroids), while a potent anti-inflammatory, can inhibit healing. What if there was another way to help reduce swelling around the nerve with a regenerative medicine approach, meaning injecting something that may help repair tissue and prompt the development of new blood vessels? Instead of high dose steroids, we have offered our patients the option of using Regenexx-PL for the past two years. PL means platelet lysate, which is the patient’s own concentrated platelet solution where the platelets are cracked open to make sure all of the growth factors are immediately available. In addition, the pro-inflammatory platelet bodies are removed. We’ve seen clinical results that are the same or better than high dose steroid injections, without the concern of many of the downside risks of high dose steroids (which can include Cushing’s syndrome or the accumulation of excessive epidural fat, further pressing on nerves). In addition, in our clinical opinion, these Regenexx-PL injections often result in longer, sustained relief.
DD is a good example of the kind of changes we’ve noted with Regenexx-PL epidural injections. This patient is a 30 year old male attorney with a two month history of lower back, buttock, and leg pain which was constant, with radiation of those symptoms into the right ankle. Bending, coughing, and sneezing all made the pain and symptoms worse. The patient had failed chiropractic and taking medications didn’t help. Three Regenexx-PL injections were undertaken every 1-2 weeks with fluoroscopic guidance at the symptomatic levels. At 2-3 month follow-up, he reported 80% reduction of lower back pain and 35% reduction in his leg pain. He was sent back to physical therapy.