Title:First Human Report of Relief of Lumbar and Cervical Discogenic and
Arthritic Back Pain after Epidural and Facet Joint Mesenchymal Stem
Cell Injection: A Case Report
Volume: 18
Issue: 7
Author(s): Joshua Sharan*, Amir Barmada, Chadwick Prodromos and Kenneth Candido
Affiliation:
- The Foundation for Orthopaedics and Regenerative Medicine, Glenview, 60025, IL, USA
Keywords:
Mesenchymal stem cells, stem cell, back pain, case report, low back pain, osteoarthritis.
Abstract: Introduction: Back pain causes tremendous patient suffering and high financial cost to the
healthcare system. Mesenchymal Stem Cells (MSCs) have demonstrated the ability to enhance healing
and reduce inflammation and pain without the deleterious side effects of corticosteroids and nonsteroidal
anti-inflammatory drugs in numerous clinical series for peripheral joint arthritis. We hypothesized that
translaminar MSC injection into the epidural space would effectively treat disc arthritis without the burden
of sedation and the risks of disc space injection. We further hypothesized that MSC injection into the
facet joints would effectively and safely treat facet joint-induced back pain. The combination of epidural
and facet joint injection would potentially treat the most recognized low back pain generators with virtually
complete safety.
Objective: We present the initial results for the first patient enrolled in phase 1 clinical trial of the efficacy
and safety of allogeneic MSCs when injected translaminarly and into the facet joints for the treatment of
recalcitrant discogenic and arthritic back pain.
Case Report: A 47-year-old male presented with complaints of 13-year-long chronic lower back pain
resistant to conservative treatment. The decision was made to treat the patient with umbilical cord-derived
MSCs. 87 million MSCs were infused intravenously. Simultaneously, 1 million cells were injected into
each of the 8 lumbar epidural facet joints and 5 million cells into the lumbar epidural space. The patient
had no adverse events or complications related to the treatment. Five days after treatment, most of his
lumbar pain was gone, and his back spasms stopped. He no longer needed to take acetaminophen or ibuprofen
and had no difficulty sleeping without medications. The patient also reported his residual cervical
radicular pain to be 98% resolved due to the injection.
Conclusion: We have demonstrated for the first time that MSC injection into the lumbar facet joints and
epidural space results in significant improvement of lower back pain and can improve symptoms in other
spinal regions without engendering the risks associated with intradiscal injections or epidural use of corticosteroids.
