Regenerative Injection therapy is based on the premise that chronic low back pain is rarely due to any single pain generator. Posterior facet joint syndrome (arthritis), myotomal or sclerotomal pain syndromes, to joint ligamentous strains as well as annular tears or desiccated discs can all be a pain generator, but so can neovascularization in paravertebral tissue beds and within the epidural space.
Below is a table which shows a simple algorithm for the treatment chronic low back pain.
Images below show that of a patient, 83 years young male, who at the time was ranked Number 1 in his age category and claimed the Seniors World Masters Tennis Championship. Here this procedure is a work of art. He now only presets on a needs be basis.
AP View
Lateral View
There are instances where some patients have no other option when they present with a complex pain syndrome. Please be assured that in the undertaking of a such a procedure careful consideration and planning goes into it as well as the surgical skills required, and patients do remarkably well.
From a regenerative medicine perspective a possible treatment protocol to complement this would be the use of Ortobiologics/Cellular-Dextose Prolotherapy and subcutaneous/deep perineurial hydrodissection approaches.
A Regenerative Injection Therapy Algorithm for the Treatment of Low Back Pain may include..
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Category I: Non-specific low back pain |
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Category II: Radiculopathy/paresthesia |
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Category III: Discogenic pain; determined by patient report of midline lumbar pain made worse bending forward accompanied by disc desiccation on MRI (decreased signal strength upon T2 weighting); with or without radiculopathy/paresthesia |
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