Intervertebral Disc Injection NJ

Intervertebral discs lie between each vertebra of the spine. These discs form fibrocartilaginous joints that chronic failed back painallow movement of the vertebrae and hold the vertebrae together.

The main function of a disc is to act as a shock absorber. The outer fibrous ring of the disc is called the annulus fibrosus, and this structure surrounds the jelly-like center, which is called the nucleus pulposus. There are 23 discs in the spine: 6 in the cervical region (neck), 12 in the thoracic region (mid-back), and 5 in the lumbar region (low back).

Pain management specialists use two types of disc injections to relieve pain and promote healing: the cellular disc injection and the intradiscal injection.

Stem Cell Disc Injection

If you suffer from chronic low back pain from degenerative disc disease or spinal arthritis, and you have not had relief from standard medical treatments, you could benefit from a cellular disc injection. The doctor will evaluate your condition and consider this therapy.

The body’s tissues are constantly regenerating and rebuilding themselves as a person ages and grows. The bone marrow assists with the regeneration process by producing mesenchymal cells, which reach body parts via the blood stream. The mesenchymal cells can transform into any type of cell in the body, and they are often referred to as “stem cells.”

The discs are tough, fibrous structures that have a jelly-like central core, which is called the nucleus. Because the discs age and do not have much blood flow into them, they easily become irritated and degenerative. Because of the lack of blood flow, it is hard for the body to deliver healing cells and other substances to the disc, so it can repair itself. As a result, a disc does not properly heal when injured.

During the cellular disc injection procedure, the doctor harvests your own bone marrow to obtain mesenchymal stem cells and inject them into the diseased disc or discs. This procedure is performed using x-ray guidance to assure that the cells are injected into the precise location.Disc Injection

Often, nerve blocks, steroid injections, and oral medications are used to facilitate the cellular disc injection process. While this treatment does not cure low back pain, it does improve pain in the majority of patients.

Intradiscal Injection

The intradiscal injection is done for diagnostic and therapeutic purposes. When done diagnostically, a local anesthetic is injected to temporarily block pain and to determine if the pain is associated with a particular disc. For treatment, a steroid is injected into the disc to decrease inflammation. The long-acting steroid may take up to three days to provide pain relief, however.

Before the procedure, an intravenous (IV) line is administered for mild sedation and antibiotics, which are given during the procedure. The patient is positioned face down with a pillow under the abdomen to elevate the spinal region. Using x-ray guidance, the doctor injects a small amount of contrast solution to ensure the medication will pass through to the right region of the disc. Once the needle is in position, anesthetic and steroid are injected into the disc.

spinal cord stimulator placementAfter the procedure, the patient will be monitored for approximately 30 to 40 minutes. Once the anesthetic wears off, there will be some mild discomfort at the injection site for 24 to 48 hours. To relieve this, ice packs can be applied to the region. Most patients enjoy months of pain relief from the intradiscal injection.

Effectiveness and Outcomes of Disc Injections

Several research studies support the efficacy of intradiscal injections. Because these procedures are fairly new, little long-term results are available. However, in a study of 92 patients with pain related to intervertebral disc herniation, the results at six months were encouraging.

In addition, one study of 183 patients who had intradiscal injections were found to have decreased incidence and degree of ossification and calcification five years after the procedure. In addition, studies have shown that the injection of stem cells into the discs improved maintenance of water content and height. Experts believe that the injection of these cells into patients will lead to restoration of the extracellular matrix (ECM).

Resources

Duquesnoy B, Debiais F, Heuline A, et al. Unsatisfactory results of intradiscal injection of triamcinolone hexacetonide in the treatment of sciatica caused by intervertebral disk herniation. Presse Med. 1992 Nov 14;21(38):1801-4.

Ito S, Usui H, Maruyama K, Muro T. Roentgenographic evaluation of ossification and calcification of the lumbar spinal canal after intradiscal betamethasone injection. J Spinal Disord. 2001 Oct;14(5):434-8.

Orozco L, Soler R, Morera C, Alberca M, Sanchez A, Garcia-Sancho J. Intervertebral disc repair by autologous mesenchymal bone marrow cells: a pilot study. Transplantation 92(7):822-828, 2011.