What are PRP and Marrow Cells?
All human bodies contain some cells and growth factors that are designed to help reduce inflammation and allow the body to heal itself from any damage and injury. PRP stands for platelet rich plasma and is harvested from one’s blood by simple blood draw. Marrow cells are typically harvested from iliac crest which is the large pelvic bone that you feel from the side of your waist.
The harvesting of PRP and bone marrow contains many rich growth factors and cells that have been shown to potentially decrease pain, inflammation and possibly allow repair of damaged areas and augment healing. Some of the cells in the marrow are also mesenchymal cells that might be part of the harvest. Click here for further info about mesenchymal cells.
How Do these Cells and Growth Factors Work?
No one with 100% certainty can tell exactly how they work on the cellular level and exactly every single pathway. Recent papers and literature (PRPseminar.com) have shown that they can potentially decrease pain associated with some osteoarthritis conditions and help the body heal from an injury. Dr. Melamed in 2014 was himself a recipient of PRP and bone marrow stem cells for his shoulder and knee due to early arthritic changes. After waiting 6 months and seeing the MRI changes and improvement in his own condition, he started applying PRP and bone marrow cells in Feb 2015 to help his own patients to avoid surgery, especially younger patients.
Dr. Melamed has been extremely selective on who he uses these cells and growth factor therapies. Most of the patients have done very well. There have not been any adverse events or mishaps from PRP and bone marrow use. For the rest of the patients, it simply didn’t work. We still don’t know why it works in some patients and doesn’t work in others.
How PRP and Bone Marrow Treat Back Pain?
Dr. Melamed has seen some excellent results using this procedure to treat back pain related to conditions such as:
- annular tear
- disc desiccation
- disc bulges
- disc tear
- degenerative disc disease
- discogenic low back pain
- modic endplate changes
Dr. Melamed has also used the same treatment for degenerative changes and loss of cartilage in joints such as the knees with excellent results.
These are conditions that can be causes of back pain due to abnormal wear and tear which cause pain due to local inflammation. The goal is to use these modalities to potentially decrease inflammation which then potentially decreases pain and ultimately may augment the body’s ability to repair the damaged area.
We are still in the very early stages of learning about these cell and growth factor therapies and more and more data is still becoming available and further research is needed. Although successful on many patients, there are still some patients who do not get better. This treatment is offering another avenue of potentially avoiding surgery, although surgery may still be needed.
As time passes and more information about cell use and growth factors is uncovered, expect these procedures to become more common.
What happens during PRP and marrow cell treatment with Dr. Melamed?
This minimally invasive strict sterile procedure uses marrow cells from iliac crest and platelet rich plasma harvested from the patient’s own blood. The procedure is done under twilight anesthesia, takes about 30 minutes to complete, and allows patients to return to desk work within a day.
In the pre-op holding area, blood is drawn from the patient for PRP preparation. Then the patient is brought to the operating room and a needle is used to aspirate bone marrow from the iliac crest. The bone marrow is then immediately processed to extract the patient’s own potential mesenchymal cells and protein factors. This mixture is then injected into the intervertebral discs using fluoroscopic guidance or into the knee. The patient spends about 30 minutes in observation after the procedure and is sent home the same day.
This procedure is an excellent alternative to spine surgery or joint replacement for young and even some older patients with back and joint pain who wish to remain active. The procedure can work to decrease pain from inflammation and might even slow down or halt degenerative inflammatory changes. Intradiscal injections may delay or even eliminate the need for future spine surgery such as fusion or disc replacement.
Learn More About PRP and Marrow Cell Therapy
If you would like to learn more about possible PRP and cell therapy for back pain in Marina Del Rey, contact the SpinePro team of Dr. Hooman M. Melamed to see what can be done for you.