Regenerative Orthopedics in Low Back Pain

Low back pain is one of the main causes of physical disability affecting both youngsters as elderly and has huge impact at the socioeconomic and biopsychosocial level.

In Cirugía Deportiva De Colombia, we provide an integral management of our patients with different therapeutic

options. As a key element of treatment, we have the orthobiologics: Plasma Rich in Growing Factors and Stem Cells, elements extracted from umbilical cord and potentialized to exert a regeneration process in affected tissues.

These procedures are minimally invasive and completely outpatient.

As to determine the best therapeutic option for back pain we have to identify the main cause of pain which includes different possibilities:

• Disc Hernias

• Nerves Irritation

• Facet Arthrosis

• Musculoskeletal Disbalance

These different causes can be found in an insulated way, even generally we find all of them in the same patient with chronical and/or limiting pain.

Three first options are susceptible to management with regenerative orthopedics and this latter does not require that, because with customized physical therapy the results are very satisfactory.

Ortho-Biologic Options.

Plasma rich in Growing Factors (PRGF):

This is blood is from the patient him/herself with high concentration of platelets, process carried out by means of centrifugation. This is extracted on the same day of the procedure and it is processed for an approximate period of 1 hour.

It is frequently used due to its security and regenerative potential because stimulates the cellular recruitment, proliferation and differentiation by means through the number of growing factors and proteins released by the platelets which have the capacity of approaching the disrupted cells. Same way, platelets join the edges of degenerated disc teardrops, what leads to scarring of fibers.

Autologous Stem Cells:

Extracted from the patient him/herself: from bone marrow and /or fat tissue, procedure carried out in operating rooms, in approximate time of 40 minutes under care of one anesthesiologist under sedation and local anesthesia, this does not require any sick leave and it is completely outpatient.

These tissues are sent to a specialized laboratory for differentiation and expansion of mesenchymal stem cells

(cells culture) culture approximate time is 15-25 days.

Stem cells perform immunomodulating functions and have the ability to trigger a cascade of information which “reactivates” or regenerates ill cells for they go back to fulfill their function.

In the punctual case of disc degeneration there are studies showing that environment restoration by induction in production of proteins and collagen.

Allogenic Stem Cells.

These are cultured under GMP conditions, following internationally validated protocols. These cells are produced in batches, which before of being released for use, are evaluated with sterility tests and tests for detection of bacterial endotoxins and mycoplasma, in addition to karyotype and characterization by means of flow cytometry.

Ortho-biologics Applications

This is executed under imaging guide, i.e. guided by fluoroscopy or tomography to assure an adequate implantation, with local anesthesia and outpatient way, the time of application varies as per the quantity of structures to be treated.

What to expect?

It is probable that on implantation day and until 3 days after that a little more pain than usual appears, after third day a physical therapy must be begun and improvement of symptoms is observable as from second week post implantation.