Biologic disc treatments

[wilsonrob]

Crystal,

I have had 2 ADR's at L4/5 and L5/S1. Now I have some problems with L3/4 with front thigh weakness and pain in back. I want to try the Biostat Fibrin sealant. Who performed this for you? Was it part of trial? Thanks

[mmglobal]

Rob, I have several clients who've received the fibrin sealant, some with good results, some were not successful. I like Dr. Kevin Pauza in TX for this.

The Nucore is not really a biologic treatment. It's basically performing a nucleus replacement via injecting a flowable hydrogel into the evacuated disc following a discectomy. There are other nucleus replacements that can be inserted endoscopically.

Nucore is similar to the Dascore nucleus replacement except that with Dascore, the flowable polymer fills the evacuated disc space inside of a balloon that inflates with the polymer as it's pushed into into it. The Nucore system does not use a balloon to contain the nucleus replacement. It is simply a hydrogel that directly fills the cavity created by the discectomy.

Mark

[Aaron]

My problem with all these studies is that I could do a test on the benefit of drinking beer on discs and a small group of people would report benefits on pain and tests may even show positive results, but how do you determine a test or procedure that has repeatability and whos success spans the population not just hand selected people. There are so many variables that are not studied, what percent would heal normally, time line patients have been hurting to be called chronic, etc. Vax-d, IDET etc. all had such studies promoting their products and are now considered not to work very well.

Most doctors I have seen consider disc regeneration the holy grail and are on board but consider time and testing the determining factor. I for one look at it in terms of quanity. If fibrin did work doctors would make a fortune injecting it in every soul with DDD and still do surguries on ones that don't fit criteria. I know money is a great motivator , but several breakthroughs in the last 100 years in medicine offered great benefits to patients that saved lots of money compared to old standards.

But one variable to is that if one person gets better from IDET, technically it is a success. Albeit only for that one person and their doctor, but a success no doubt. So it is such a slippery slope to decipher these studies and decide what is viable for the population and what might help one, because money has to be there.

I hope they do discover a treatment for disc degeneration because I just dont buy the healing on your own from tears etc. The anatomy of a disc just does not give me any reason to think a tear with any supplement can heal with gravity and pressure constantly on it from standing up and sitting. It would seem any healing done when laying down would introduce a strained disc to gravity when you stand up and the cycle would repeat with the disc tearing what has healed. The studies I have been reading about tears healing dont seem to do a discogram post healing to see if the tear is really there, they have gone off MRI for high intensity zone disappearing. I would like to see a discogram done post healing, but I am sure no one wants to pressure up a disc they think just healed.

[mmglobal]

Aaron, you have a healthy level of skepticism.

I disagree about the beer study. A LARGE number of drinkers would certianly get improvement from this therapy. I have experienced great benefit, even regeneration of my discs and healing of my annular tears from drinking beer. Sadly, my spine was just to severely damaged for the beer to overcome the DDD. I tried.

[Crystal33]

Rob,
I have not had the fibrin procedure, but it is one of only a few minimal approach possibilities for me. There are a number of very happy patient outcomes posted about it on the net. As Mark mentioned, Dr. Kevin Pauza in TX is name mentioned. A phase III trial indicates they are serious about it.

Aaron, Mark
Beer in quantity would be effective pain management.
But wine is needed for disc regeneration.
The Action of Resveratrol, a Phytoestrogen Found in Grapes,... : Spine
And glucosamine to help heal tears.
The complete Homer spine care system.

[Aaron]

I am a skeptic but I am very interested in Dr. Pauza trials. But damn, the criteria and testing to make sure you are a good fit is crazy, if what I read about the trial is true. But I am excited as it says if the trial works he wants to expand to cervical and thoracic spine injections.

As spine patients I think I fall into the " I will try anything once " category when dealing with spine so I am trying to contact him concerning if he is going to do a thoracic trial for fibrin. Props for bringing this study to my attention crystal.

Yea Mark I started my own trials on the benefits of beer long ago. Have not yet found many, but I still trudge on ( for the good of man of course).

In all seriousness could you imagine if wine was discovered to work. Sales would hit the roof.

[Crystal33]

Aaron,
I do have a little more red wine than usual, to help the scientific research.
I suspect that a comprehensive and disciplined multi modality approach would be needed to slow/halt/reverse early disc degeneration. A disc without full thickness tears might also be needed, and a youngish age would also help.

This current trial is hoping to reverse early lumbar disc degeneration by a single injection.
Degenerative Disc Disease Clinical Trial: A Multicenter, Randomized, Double-blind, Placebo Controlled, Clinical Trial to Evaluate the Safety, Tolerability and Preliminary Effectiveness of Single Administration Intradiscal rhGDF-5 for the Treatment of

And this recent study claims non-surgical spinal decompression reduces back pain and increases disc height, which would be one ingredient to any regeneration. I think the decompression might work best before a person went to sleep so that it wasn't followed by loading up the disc again and maybe undoing any benefit.
BioMed Central | Full text | Restoration of disc height through non-invasive spinal decompression is associated with decreased discogenic low back pain: a retrospective cohort study