Stem cell treatments for orthopedic and spinal conditions
We all have stem cells circulating throughout our body. Whether we are 91 days or 91 years old, we all have stem cells. These cells, called “Mesenchymal Stem Cells” (or MSCs) typically live in the bone marrow and when we are injured these cells are “recruited” out of the bone marrow and are sent to different parts of the body to help with healing. How do stem cells know where to go? Well, there are actually a couple of different ways — naturally circulating chemicals called “cytokines” are chemical signals that attract stem cells to an area of injury. Additionally, when we are injured or cut we will typically bleed. As a part of the healing process, platelets initially stop the bleeding, but then they also go to work by releasing different growth factors and chemicals that also help to attract stem cells. Once the stem cells get to an area of injury, they begin to assist in healing.
Normally, when we are young, our stem cells are all very healthy and numerous. As we age, the overall population of stem cells in our bone marrow declines. And to add insult to injury, there is an even greater decline in stem cell numbers in exactly the places where they are needed most, such as the hips, knees, and spine! This just doesn’t sound fair, does it? As you can imagine, as we age, if there are fewer and fewer stem cells living under the surface of the cartilage in these weight bearing joints it gets harder and harder to heal the injuries that we experience in these joints over time.
What if we could “game the system” and take stem cells (MSCs) from areas where they are relatively plentiful and inject them into areas where they are relatively deficient?
This is exactly what is being done when we use stem cell injections for orthopedic conditions. During a stem cell procedure, we use image guidance, including live x-ray and/or ultrasound guidance to extract stem cells from the bone marrow in the iliac crest —one of the areas where they are relatively plentiful. (The iliac crest is the “hipbone”, where you put your “hands on your hips.”) The extracted bone marrow is concentrated in a highly specialized centrifuge system that maximizes the number of stem cells into a small volume of fluid, which is then injected into damaged knees, hips, shoulders, and spines using a small needle instead of a scalpel, laser, or bone saw!
Once the MSCs are injected into the target area, the hope is that they begin to communicate with the other cells nearby and help to encourage a “stalled” healing process. In some cases, the stem cells will serve as a “spark” to start a healing process which had never even begun, due to poor blood flow, excessive inflammatory chemicals, or other factors.
We will stem cells grow a new knee, hip, or shoulder? Probably not. However, the improvements in pain, function, and quality-of-life that we are seeing —in study after study involving stem cells—cannot be ignored. There seems to be a great healing power contained in the stem cells that we all have in us from birth until death. Thankfully, we are now entering into a phase of medicine where we are able to harness and focus the power of stem cells, offering patients options and hope, where little or none previously existed.