Posts By: Florida Spine Specialists
Discography / Stem Cell Injection
The purpose of Lumbar discography is to Identify if one of the lumbar discs is the source of the pain being experienced by the patient. Lumbar discography is indicated as a diagnostic maneuver in a carefully selected subset of patients suffering from back and lumbar radicular pain.
Patients who may benefit from discography include:
- Persistent back pain in which traditional diagnostic modalities failed to delineate a cause of the pain. (MRI, CT scan, EMG, etc.)
- To identify if disc bulges are responsible for the pain.
- Patients who are to undergo lumbar fusion, where discography may help identify which levels need to be fused.
- Patients who had previously undergone fusion, where discography may help identify whether levels above or below the fusion are responsible for persistent pain.
- Patients with recurrent disc herniation cannot be separated from scar tissue with traditional imaging techniques.
As dye is injected into the disc, the pressure increases which will elicit the patients pain if the disc is compromised. The dye may also leak outside the disc demonstrating a tear or fissure within the disc fibers. The pain should again be remedied after injection with anesthetic.
If the disc is found to be compromised or the source of the patients pain then Autologus Mesenchymal Stem Cells can be injected into the disc to aid the body in repairing the disc.
What is Regenerative Medicine:
Regenerative Medicine is a holistic approach to aid in the treatment of joint pain, spine pain, injuries and /or degenerating tissue. Biocellular regenerative medicine uses your body’s own ability to repair, replace or regenerate injured or wore out tissue.
Regenerative medicine therapies include: Biocellular Stem Cell Therapy, Platelet Rich Plasma (PRP) Therapy and Prolotherapy.
What is a Stem Cell
Stem cells are our body’s repairmen and can be harvested from bone marrow. They are self-renewing cells that help repair injured bone, ligaments, cartilage and tendons and act as firs responders when there is injury to a tissue. We extract stem cells from bone marrow and place them where they are needed most, the injury. By introducing these cells into the areas where our body needs repair (i.e. damaged or worn cartilage, injured tissue, painful joints, etc.) our body can begin repairing itself without surgery. At Florida Spine Specialists, we use stem cells in many of our treatments to create an environment of optimal healing.
Orthopedic conditions can be treated with stem cells that are derived from the patient’s own bone marrow. This is performed at Florida Spine Specialists in the procedure / OR suite. The stem cells are extracted from the hip (Bone Marrow) and sent to our lab where they are separated, collected and prepared for reinjection into the patient’s joints. Bone marrow extraction is performed under local anesthetic and taken from the iliac crest. Injecting Bone marrow concentrated stem cells is performed under either ultrasound or fluoroscopic guidance. Once the damaged area is identified, the needle is guided to the injured site and the stem cells are infiltrated to that area. This process takes about an hour from start to finish. The patient is monitored throughout the entire process and discharged to home with instructions.
What are Platelets
Platelets are a component of blood that contain hundreds of proteins called “growth factors.” Although platelets are best known for their clotting abilities, they are very important for repairing injuries. When extracted from our own blood and injected into an injured area in a concentrated form, the concentration of growth factors in the injured area actually speeds the healing process. At Florida Spine Specialists, we use your body’s platelets as a catalyst for healing and regeneration of tissue.
PRP therapy is the natural, effective solution for orthopedic pain relief
Platelet rich plasma (PRP) injections are replacing traditional orthopedic surgery in many instances for conditions that range from soft tissue injuries (tendonitis, muscle tears, ligamentous injuries) to various joint afflictions, such as a torn meniscus or mild to moderate arthritis of the joints. Regenerative techniques can be tailored to meet each patient’s orthopedic needs wherever he or she is experiencing discomfort.
The treatment of PRP is relatively simple and can be completed in one session. We collect the PRP by drawing a small amount of your blood, putting it into an FDA cleared device, placing it in a centrifuge and spinning it until the platelets separate from the blood. The PRP is then injected into the areas of concern to begin the regeneration and healing of both soft tissue injuries and various joint afflictions.
What is Prolotherapy
Prolotherapy is a nonsurgical treatment which stimulates healing. Short for “proliferation therapy,” Prolotherapy is also known as nonsurgical ligament and tendon reconstruction, or regenerative injection therapy. Prolotherapy works by stimulating the body’s own natural healing mechanisms to repair injured musculoskeletal tissue.
Prolotherapy causes a temporary, low grade inflammation at the injection site, activating fibroblasts to the area, which, in turn, synthesize precursors to mature collagen and thus reinforce connective tissue. It has been well documented that direct exposure of fibroblasts to growth factors (either endogenous or exogenous) causes new cell growth and collagen deposition. Inflammation creates secondary growth factor elevation. The inflammatory stimulus of Prolotherapy raises the level of growth factors to resume or initiate a new connective tissue repair sequence which had prematurely aborted or never started. Biopsy studies show ligament thickening, enlargement of the tendon-osseous junction, and strengthening of the tendon or ligament after Prolotherapy injections.
Prolotherapy is used for musculoskeletal pain or injury which is either unresolved after eight weeks, or (if earlier) where enhanced healing is desired. Prolotherapy can be used years after the initial pain or problem began, as long as the person is healthy. Because Prolotherapy works to repair weak and painful joint areas, it is a long-term solution rather than a temporary measure such as drugs or Cortisone. Typically, two to four treatments are given at monthly intervals.
Florida Spine Specialists are not representing or offering “stem cell therapy” as a cure for any condition, disease, or injury. No statements or implied treatments on this website have been evaluated or approved by the FDA. This website contains NO medical advice. All statements and opinions provided by this website are provided for educational and informational purposes only and we do not diagnose or treat via this website or via telephone. Florida Spine Specialists offer treatments that are in the investigational stage to provide individual patients with tissue Stromal Vascular Fraction that contains their own autologous stem cells and growth factors. This center provides minimal surgical procedures only and is not involved in the use or manufacture of any investigational drugs.
Florida Spine Specialists represents that it is VERY important for potential patients to do their own research based on the options that we present so that one can make an informed decision. Any decision to participate in our patient funded experimental protocols is completely voluntary.
The Florida Spine Specialists are proud to sponsor the CG Hearts of Gold charity. The CG Hearts of Gold is a Fort Lauderdale based organization and the following information can be found on their website:
We are proud to be continuing this mission more than 65 years later.
There are good and bad exercises for low back pain and exercise plays an important role for lower back pain relief. The Florida Spine Specialists have created a video that illustrates 4 Exercises For Lower Back Pain Relief. The four specific exercises for back pain relief are Quadruped Arm and Leg Raises, Ball Squeezes, Hip Flexion Isometric, and Wall Push Ups. There are specific low back pain exercises and simple moves to eliminate your pain including exercises for lumbar spinal stenosis.
Call or visit the Florida Spine Specialists to schedule a physical therapy session.
A recent patient of the Florida Spine Specialists provided us a review of her Superion experience. Watch this two-minute video about a patient’s success with Superion. The patient was suffering from Spinal Stenosis and tried previous treatments that failed to relieve the pain. After Dr. Cairn’s, from Florida Spine Specialists, treated the patient with Superion, the patient was able to walk away pain-free and has been pain-free ever since. We thank the patient for sharing her story.
Dr. Kairns will be discussing the Superion procedure at a seminar in Fort Lauderdale. For more information visit, http://www.vertiflexspine.com/news-events/free-superion-patient-seminar-fort-lauderdale-fl/
Surgical and Non-Surgical Treatments for Spinal Disc Herniation
Spinal discs are the spine’s shock absorbers that keep the vertebrae from bouncing against each other. They also work to support the upper body while allowing for a wide range of movement. If one of these discs is damaged then the functionality of the entire spine is seriously impeded.
A herniated disc is when the soft jelly-like tissue at the center of the spinal disk pushes through a crack in the bone that holds it. Herniated discs are usually the result of extreme stress to the spine caused by heavy lifting or twisting too far around. People of any age can herniate a disc however it is most common among people aged between 35 and 50.
Treatment for herniated discs is designed around relieving the patient of pain. For the treatment to be effective, it must be tailored to the specific needs of the patient. Non-surgical options are always explored before the doctor advises the patient to go under the knife however it may be in some patients’ best interests to go into surgery immediately. This is usually the case when patients have no bowel control or increasing weakness in their limbs because the slipped disc is pinching on a vital nerve root and immediate surgery is needed to prevent permanent nerve damage or loss of life.
Up to 90% of all slipped discs can be treated without the need for surgery. Pain in the limbs associated with slipped discs can be treated using medication. If the pain continues to reduce then there is no need for surgery and the doctor can be confident that the numbness will dissipate in time.
The pain that comes with a herniated disc is because of a combination of two conditions. One is when the herniated disc has moved to a position where it is pinching on the nerve root and the other is when the tissue around the slipped disc becomes inflamed. Treatments for pain associated with slipped discs are designed to take care of both these issues simultaneously. Anti-inflammatory injections of cortisone are given along with pain-killers such as ibuprofen. Steroids can be prescribed in cases where the patient feels extreme pain however not for more than a week.
With a disc that is out of place, some light manual manipulation may help to set it right again. Chiropractic healthcare from a professional chiropractor could help to massage the slipped disc back into place and get the joint functioning well again. Moving the joint back into place must be done slowly as trying to force it back in may result in nerve damage.
When the patient’s pain has reduced they are advised to engage in physical exercise and therapy to reduce the muscles spasms and getting it strong again.
Doctors will always use surgery as a last resort. Most herniated discs can be treated without surgery however there are some cases where the patient is experiencing increasing amounts of pain or numbness and the doctor must operate to save the patient’s life.
Spinal surgery to fix herniated discs is generally successful with a success rate as high as 98%. There are several way to perform a surgery on a herniated disc. Anterior cervical discectomy and spine fusion is the most common method that surgeons use to fix cervical herniated discs. In this procedure the disc is removed and the space is fused. Sometimes the surgeon will place an artificial disc instead of fusing the space which is called an artificial disc replacement.
Posterior discectomy is similar to the anterior approach but more risky because there is high number of veins in this area of entry that can result in a lot of bleeding. It also requires the spinal cord to be manipulated more.
Sciatica: Symptoms, Cause, and Treatment
Sciatica is a symptom of pain in the lower back area, caused by compression or irritation of the sciatic nerve.
The sciatic nerve is the longest nerve in a human body, running from the back of the pelvis all the way down both legs.
Sciatica can be a symptom of several other medical conditions rather than a condition on its own, which will be described below.
Symptoms of Sciatica
Sciatica can cause several common symptoms including:
-lower back pain, ranging from very mild to very painful.
-Pain in the buttocks and legs that generally worsens during sitting period
-Weakness, numbness, and tingling sensation on the mentioned areas, especially in the affected leg and can cause difficulty of movements
-Constant pain on one side of the buttocks
Symptoms of sciatica usually affect both legs and buttocks more often than general back pain, the pain can be made worse by sitting for a long period of time, sneezing, and coughing.
Causes of Sciatica:
Sciatica is mainly caused by lower lumbar and lumbosacral spine irritation, which in turn compress and/or irritate the sciatic nerve.
This condition, however, can be caused by other medical conditions such as:
-Lumbar Herniated disc
Spinal discs act as cushions and shock absorbers between each vertebra. When a disc is damaged, it can break open and rupture creating a herniation. Herniated disc is more common for the lower back (lumbar) area rather than upper back or neck.
While a herniated disc won’t cause any pain when there’s no contact with the nerve, sciatica can happen when the herniated disc pressed on the sciatic nerve.
-Lumbar Spinal Stenosis
Spinal stenosis refers to the narrowing of spaces in the vertebrae (spine), which in turn will cause pressure on the nerves and the spinal cord itself. 75% of spinal stenosis occurs in the lumbar (lower back) area.
When the narrowing creates pressure to the sciatic nerve, sciatica can occur as a symptom.
-Degenerative Disc Disease
Not actually a disease as the name suggest, this condition refers to the degenerative changes on the spinal discs as we age, which can include loss of fluid in discs and tiny breakdown in the outer layer.
More commonly happen in the lower back (lumbar area), it can cause sciatica when the degenerated disc is located near the sciatic nerve.
The slipping of a vertebra caused by a fracture of one or both wing-shaped parts of the bone. When such occurrence happens, the vertebrae can slip backward of forward over the bone below.
Other common cause that may cause sciatica can include:
Pregnancy can put more strain in the lower back area, and in turn, can irritate the sciatic nerve.
Being overweight means more pressure are put on the lower back area, often compressing and irritating the sciatic nerve.
Cramping in lower back or buttocks can cause sciatica.
Being in a bad posture for a prolonged time can strain the lower back muscles and irritate the sciatic nerve.
Treatment of Sciatica
On most cases, no specific treatment is necessary for sciatica. The condition can naturally improve over the period of approximately six weeks.
However, in more severe cases, or when the pain becomes persistent, some methods of treatments are available below:
Some self-treatment to help reduce the sciatica symptoms are as follows:
1. Being Physically Active
Physical exercise will reduce the pain associated with sciatica, as well as strengthen the muscles that support the lower back area.
Bed rest, when prolonged, can be counterproductive for sciatica symptoms, and one should aim to return to being active as soon as possible.
2. Compression Packs
Using hot or cold compression packs depending on preference can reduce the severity of the pain.
When the pain becomes unmanageable, or persistent, painkilling medications such as paracetamol, ibuprofen, amitriptyline, or in more severe cases, morphine, can help reduce the associated pain.
Your general practitioner may refer you to a physiotherapist.
Physiotherapy can strengthen the lower back muscle, improve the flexibility of the spine, as well as improve your posture to reduce further strain on your lumbar.
Usually utilized for severe cases, spinal corticosteroid or local anesthetic as a strong painkiller can be an option.
Surgery is very rarely a necessity for sciatica, however, then the sciatica is a symptom of other, more severe diseases as mentioned before, surgery can be considered.
For example, herniated or slipped disc will sometimes need surgery as a necessary treatment.
Correct diagnostic of the cause is necessary before deciding a surgical option, as surgical procedures will also vary with different causes, such as:
-Laminectomy is often utilized for spinal stenosis, removing the lamina of the vertebrae
-Discectomy is more common for herniated disc, removing the part of herniated disc that pressed the sciatic nerve
-Fusion surgical method is utilized to fuse a slipped vertebra, using a cage (metal or plastic) between the vertebra to support it back to position
This lecture was recorded at Emergency Medicine Grand Rounds On August 17, 2015. The speaker is Dr. Kevin Cairns, an attending physician at Broward Health Medical Center since 2006. He is a leader in the field Physical Medicine and Rehabilitation and an expert in the treatment of back pain using non-invasive and minimally invasive techniques. He has authored countless publications and has lectured extensively on topics related to the spine. In this lecture, he will cover the diagnosis and treatment of vertebral compression fractures.
A doctor at Florida Spine Specialists recently spoke at the annual American Society of Interventional Pain Physicians (ASIPP). “We’re not needle jockeys and we’re not running pill mills,” said Harold Dalton, DO, president of the Florida Society of Interventional Pain Physicians, kicking off the annual meeting of the group, held this year in Orlando, FL, “We are doing right for our patients.”
Read the full article on HPCLive.