Intradiscal Bone Marrow Concentrate Injection

Intradiscal Bone Marrow Concentrate Injection
For Discogenic Low Back Pain:
Patient Introduction

What is bone marrow concentrate (BMC)?

Bone marrow concentrate, or BMC, is a procedure in which we use your own bone marrow to treat a painful condition. A small amount of bone marrow is taken from the pelvis and then minimally processed in a centrifuge. The BMC contains growth factors and stem cells which promote healing of injured or degenerated tissue. We then inject your own BMC back into the specific area causing your pain. Studies have shown that this type of treatment may help alleviate some types of pain.

What is intradiscal BMC injection?

It is known that about half of all low back pain originates from the intervertebral disc, specifically small tears in the outer portion of the disc. This is often called “discogenic pain.” Intradiscal BMC injection is a procedure in which we use bone marrow in hopes of healing the disc tissue. If your physician feels that your low back pain may be stemming from the intervertebral disc, you may be a candidate for BMC.

What occurs during the BMC procedure?

This study is a double-blind placebo controlled study. What this means is that most patients (67%) will receive the “real” procedure with bone marrow concentrate and some patients (33%) will receive the “pretend” or placebo procedure. You will not be able to choose what treatment you receive. It will be selected randomly by a computer. The person who discusses all of the risks and potential benefits for the procedure will also not know what treatment you will be receiving.

The procedure begins with aspiration of the bone marrow from the pelvis. This is done in a sterile procedure and the area for drawing the bone marrow will be numbed with a local anesthetic. Some patients will be given oral or IV sedation prior to the procedure. The bone marrow will be minimally processed. Under x-ray guidance a needle will be placed into the disc (or discs) that are felt to be causing your pain. A small amount of contrast dye, antibiotic and anesthetic will be injected into the disc. The BMC is then injected into the disc. All of this is performed in our office. Although the procedure itself takes 45 minutes to 1 hour, you will be in the office for 2-3 hours total.

If you are assigned to the placebo group, a similar procedure will be performed but you will not actually have bone marrow injected into the disc.

Would intradiscal BMC help me?

We begin the process by determining if we feel your pain is coming from the intervertebral disc. We make this determination from your clinical history, physical examination, imaging studies and other diagnostic tests. Studies of BMC on disc tissues are new and ongoing. There is promising data on the healing effects on discs with BMC treatment. In particular, there is a single study which showed that the majority of patients who underwent a disc treatment with BMC had very good results. Over 60% of the patients in that study reported that the BMC treatment relieved their pain by at least 50%.

Although these early results are exciting, we will not know the extent of its benefits without further studies. The physicians at APM Spine and Sports are conducting a research study to help evaluate this exciting new treatment option. Before considering participation in this study, you should be aware of all the risks and potential benefits as well as any alternative treatment options for your condition. Our research physicians and staff will be happy to discuss this opportunity with you further.

Pettine KA, Murphy MB, Suzuki RK, Sand TT. Percutaneous injection of autologous bone marrow concentrate cells significantly reduces lumbar discogenic pain through 12 months. Stem Cells. 2015;33(1):146-56.

Pettine K, Suzuki R, Sand T, Murphy M. Treatment of discogenic back pain with autologous bone marrow concentrate injection with minimum two year follow-up. Int Orthop. 2016;40(1):135-40.