Injections of concentrated bone marrow aspirate as treatment for Discogenic pain: a retrospective analysis

Abstract

Background: There are an overwhelming number of patients suffering from low back pain (LBP) resulting from disc pathology. Although several strategies are being developed pre-clinically, simple strategies to treat the large number of patients currently affected is still needed. One option is to use concentrated bone marrow aspirate (cBMA), which may be effective due to its intrinsic stem cells and growth factors. Methods: Thirty-three patients who received intradiscal injections of cBMA to relieve LBP were followed up based on Numeric Rating Scale (NRS), Oswestry Low Back Pain Disability Index (ODI), and Short Form-36 Health Survey (SF-36) scores. Patients were also subdivided into those with a pre-injection NRS > 5 and pre-injection NRS ≤ 5. The proportion of patients demonstrating at least 50% improvement (and 95% confidence intervals) from baseline at five follow-up visits for each outcome was evaluated. Results: At least 50% improvement in NRS was observed for 13.8, 45.8, 41.1, 23.5, and 38.9% of patients across five follow-up visits, out to 1 year. When stratified by high (> 5) versus low (≤ 5) baseline NRS scores, the values were 14.3, 45.5, 71.4, 22.2, and 44.4% among those with high baseline pain, and 13.3, 46.2, 20.0, 25.0, and 33.3% among those with low baseline pain. The 50% improvement rates across visits were 4.3, 28.6, 30.0, 22.2, and 30.8% for SF-36, and 4.2, 26.7, 36.4, 55.6, and 30.8% for ODI. Conclusions: Intradiscal cBMA injections may be effective to reduce pain and improve function. Patients with relatively higher initial pain may have potential for greatest improvement.

Risks of Intradiscal Orthobiologic Injections: A Review of the Literature and Case Series Presentation

“…One hundred twenty-nine abstracts were reviewed and excluded, leaving 19 studies meeting inclusion criteria. Of these, 11 were original studies evaluating autologous bone marrow-based injections (3 of the same cohort), 12,[14][15][16][19][20][21][22][23][24][25] and 8 were original studies evaluating autologous platelet-based injections (2 of the same cohort) 11,26-33 (Figure 1). Eleven articles were review papers.…”

Mesenchymal Stem Cell Applications in Spine Disorders: A Comprehensive Review

“…One study was conducted on patients who previously underwent discectomy at the treated level [17]. All other investigations only included patients with a history of chronic lower back pain and clinical findings consistent with discogenic origin of the symptoms, with failed conservative therapy and no previous surgeries at the level of the treated disc [18][19][20][21][22][23][24][25]. A summary of the included articles is presented in Table 1.…”

Grand Challenges in Musculoskeletal Pain Research: Chronicity, Comorbidity, Immune Regulation, Sex Differences, Diagnosis, and Treatment Opportunities

“…Cell-based therapy has shown tremendous promise in the management of chronic musculoskeletal pain in recent years. Patients with disc diseases receiving intradiscal injection of bone marrow concentrate show improvement of discogenic pain through up to a 3-year follow-up ( 82 , 83 ). The clinical improvement is attributable to mesenchymal stromal cells (MSCs) in the bone marrow.…”