Disclosures: Christopher J. Centeno, MD: Regenexx (Products/Services: No) (Employment)

Objective: The aim of this study is to evaluate pain and functional outcomes in patients with discogenic lumbar pain following fluoroscopically guided intradiscal bone marrow concentrate (BMC) injections.

Design: Case series review from patient registry data with longitudinal patient-reported outcomes data. Setting : All injections were performed at a single outpatient interventional pain and musculoskeletal clinic. Participants : Patients with discogenic low back pain refractory to conservative treatment.

Interventions: All patients underwent fluoroscopically-guided intradiscal injection with BMC. One-third of patients underwent intradiscal injection alone and two-thirds also had concomitant injections to peridiscal structures including facet joint(s), ligaments, transforaminal epidural space, and multifidus muscles.

Main Outcome Measures: Main outcomes measures included numeric pain scores (NPS), functional rating index (FRI) and modified single assessment numeric evaluation (SANE) scores. Safety was assessed via adverse outcome reporting.

Results: Thirty-three patients enrolled in the registry met inclusion criteria. Nine patients underwent intradiscal BMC injection alone and 24 underwent intradiscal injection plus platelet injections to associated osteoligamentous and neural structures. For both groups combined, 30% of patients reporting sitting intolerance based on ability to travel on FRI demonstrated resolution at 6 months (p < 0.05) and 12-months (p < 0.01). SANE scores showed significant mean improvement of 50% at 12 months (p < 0.01) and 62% at 24 months (p < 0.01), compared to 1-month. Mean NPS scores decreased from 4.5 at baseline to 3 at 6-months and 18 months (p < 0.05), with 75% of meeting minimal clinically important difference (MCID) at 24 months. Two of 33 patients had transient, post-procedural pain, and one was prescribed oral antibiotics for suspected discitis. Two of the 33 patients reported disc replacement surgery. Conclusions: The findings of this case series support the use of intradiscal BMC injection within the treatment algorithm of lumbar discogenic pain, however larger studies are required to further validate these findings and better clarify safety data.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/intradiscal-injection-of-autologous-bone-marrow-concentrate-for-chronic-discogenic-low-back-pain-a-registry-based-outcomes-study/