Presented at the 2013 AAPM Annual Meeting « Back

Lumbar Disc Biologic Autograft Injection of Bone Marrow Concentrate for Treatment of Low Back Pain: Retrospective Review of 22 Consecutive Cases

D. Joseph Meyer, MD PhD¹, David Crane, MD², Kristin Oliver, MD², (1) djmeyerjr@gmail.com, Columbia Interventional Pain Center, LLP, Columbia, Missouri, (2) Bluetail Medical Group, Chesterfield, Missouri

Introduction: Autologous bio-cellular grafts are increasingly encountered in surgical literature as a means to enhance tissue repair. Biologic graft use has expanded beyond simple platelet rich plasma to encompass bone marrow aspirate concentrate (BMAC) and adipose derived autologous stem cell products. The clinical application of such grafts in the treatment of low back pain is intriguing, but remains unproven. Methods: Retrospective data were collected from 22 consecutive individuals treated in the primary author’s clinic over 18 months. Full disclosure regarding the experimental nature of the treatment was provided and written informed consent obtained. All patients presented with chronic low back pain of at least 1-year duration, with or without leg pain complaints; plus MRI or CT evidence of lumbar disc degeneration. Clinical findings were consistent with low back pain of discogenic origin. 60 cc iliac bone marrow aspirate was harvested and concentrated in an Emctye centrifuge device to obtain 8 cc BMAC: 1-1.5 cc of which was injected into each affected lumbar disc annulus using a 22 gauge Chiba needle under fluoroscopy, followed by injection of an additional 0.5-1 cc of BMAC immediately external to the annulus (maximum of 2 discs treated). Follow-up data were obtained 6 to 22 months post-treatment. Results: At follow up, patients reported changes in back pain ranging from complete pain relief to no improvement; no patients reported worsening of back pain. No complications were encountered. Conclusions: These observations support the need for future controlled prospective study of biologic autograft treatment of lumbar discogenic pain.

Funding: None