Frequently Asked Questions
Are any biological agents added to the stem cells such as PRP - Platelet rich plasma?
Yes. Adipose derived stem cell harvesting and isolation technique yields extremely high numbers of stem cells. In reviewing outcomes data, treatment cell numbers appear to correlate with treatment success. Adipose derived stem cells are actually in a type of “soup” called Stromal Vascular Fraction SVF which is stem cells bathed in a rich mixture of natural growth factors (Not the same as human growth factor hormone which is only one type of growth factor). Some types of orthopedic and urologic diseases appear to respond better to stem cells that are super enriched with growth factors created by administering Platelet Rich Plasma to the patient. Autologous Platelet Rich Plasma is derived from a patient’s own blood drawn and administered back to the patient along with the stem cells at the time of treatment.
Can stem cells cause cancer?
Adult mesenchymal stem cells are not known to cause cancer. Some patients have heard of stories of cancer caused by stem cells, which are probably related to the use of embryonic cells (Not Adult Mesenchymal Cells). These embryonic tumors known as teratomas are rare but possible occurrences when embryonic cells are used.
Does age affect the ability of stem cells to do their work?
Bone marrow derived stem cells become less numerous per unit volume after age 60. Fat derived stem cells show no such loss with aging.
Will the use of Tobacco products effect healing?
Tobacco has been known to delay healing and increase the risk of infection after surgical procedures for some time now. Abstinence from the use of all tobacco products including nicotine-containing patches and vapors is imperative for optimal response to treatment. We would hope that patients will discontinue tobacco use because of its multiple other detrimental health effects, however; for the purpose of stem cell injections twelve-month abstinence is required after the stem cell treatment..
Where do you get the stem cells from?
Stem cells are harvested from either subcutaneous abdominal fat, or from bone marrow harvested from the iliac crest which is the hip bone. Stem cells from fat are concentrated in the centrafuge to obtain as many stem cells as possible for injection.
There are always 2 parts to a stem cell injection:
- Collection of stem cells, (Harvesting) – typically taken from body fat or from bone marrow
- Application (injecting) the stem cells to the region of interest
Stem cells from fat:
- Stem cells from fat are frequently injected along with platelet rich plasma (PRP). PRP is rich in growth factors, cytokines and activators that provides an environment conducive to tissue repair.
- Typically, if stem cells are collected from body fat, a blood sample is also collected from a patient’s arm to obtain the blood plasma and centrifuged to obtain PRP, (Platelet rich plasma). This is to provide the stem cells the additional material containing growth factors and other nutrients.
Stem cells from bone marrow:
Bone marrow already contains blood plasma, platelets and stem cells and therefore there is only a single collection process to obtain what is needed for a stem cell injection. This sample may need to be further processed by your doctor depending on the site of injection. The collection site is generally from the iliac crest and is only mildly uncomfortable. Local anesthetic is applied under sedation to numb the area before collection..
Are the stem cells given on the same day as they are collected?
Yes. The stem cells are collected either from fat or bone marrow and processed at the time of the injection. Typically they can be processed within 30 minutes or less for administration. The physician then provides the injection of the stem cells to your spine or joint on the same visit as when they are harvested.
Will the injection be painful?
There are many variables as to whether an injection of any type is uncomfortable or not. Injections of stem cells to most body regions are no more discomforting than any other typical joint or soft tissue injection. Injections into a spinal disc are more uncomfortable and are typically done under sedation. In either case, the patient is discharged the same day of the procedure like any other outpatient procedure.
What can I expect after the procedure?
For most joint and soft tissue injections: patients may expect some discomfort that may last several days after the procedure but should not impair function or return to work. If a weight bearing joint is injected, we ask that partial weight bearing be observed for the 4 weeks immediately after the treatment. Other post procedure restrictions vary depending on the region injected and you should ask your clinician for those specific instructions.
Intradiscal spinal injections: Post procedure discomfort depends both on the number of discs injected and the degree to which they are responsible for pain generation. Since the diagnostic discogram is designed to provoke pain in pain generating disks it is normal for there to be increased pain after the procedure. It is typical for back pain to be increased above baseline for about 3 days after the injection. Rarely, patients may experience a prolonged exacerbation of back pain lasting weeks or even months.
Healing from these regenerative injections, whether joint or disc, takes time. It is a biologic regenerative treatment. It usually takes about 3 months for discs to respond and many times it can take 7 months for joints to respond. Studies demonstrate that healing continues for about a year.
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