Month: February 2017

Neurostimulation Applied to Back Pain

For those suffering from chronic back pain, going about daily activities can be difficult and painful. Depending on the causes and severity, medication and physical therapy may help, but a strategy that tends to see more effectiveness is neurostimulation.

Roughly the size of a stopwatch, a neurostimulator is a surgically implanted device that delivers mild electrical impulses to the epidural area of one’s spine through medical wires, or “leads.” These signals create a tingling sensation in the area of the back that is causing the patient’s back pain. Relief comes due to neurostimulation modulating the signals of pain before they reach the brain, much like rubbing a sore spot after bumping into a table, only no initial pain is felt.

The neurostimulator is placed underneath the skin, most commonly on the abdomen. Special medical wires then extend from the device delivering stimulation. Appearing as just a small bump, neurostimulators make no noise, and are very easy to control.

Controlling the level of stimulation is as easy as pressing a button. Through a handheld programmer, patients are able to adjust the strength and location depending on daily activities. For example, exercise and physical activity may demand stronger stimulation than times in which patients are sleeping, or simply relaxing.

Neurostimulation is an effective way to reduce chronic pain for several areas of the body, depending on the source of one’s pain, which can greatly improve patients’ daily activities and overall quality of life. Those who have seen success experience anywhere from 50% to 70% less pain depending on the provider, and a reduced need for anti-inflammatory medications. Additional bonuses of successful implants include no damage to the spinal cord, easy adjustability, and the option to have the implant turned off.

However, there are risks that come with having a neurostimulator surgically implanted, much like all pain treatments. Common side effects of this procedure include little to no stimulation due to movement of the leads, stimulation in wrong areas of the body (also due to lead movement), pain at the site of the implant, and transmission problems between the implant and the handheld programmer. Some side effects may be more serious though.

Like most surgeries, the risk of infection is present. Hematomas and fluid is also prone to leaking where the stimulator was implanted. Further complications may require additional surgery to relocate, repair, or replace specific parts of the device, and in rare cases, spinal cord injury may occur due to incorrect placement.

 
As mentioned before, depending on one’s severity and causes of back pain, neurostimulation may be the best option in relieving symptoms. Therapy sessions are available for those that wish to test this strategy before having surgery, so speaking with your physician about whether or not this is the right decision for you is highly suggested.

Benn Willcox allograft

Osteoblastic and Stem Cells from Bone Allografts

Osteoblasts are single nucleus cells that synthesize bone, which function in groups of connected cells during the process of bone formation, as individual cells cannot create bone. Successful bone fusion relies on three crucial components: an osteoconductive matrix, an osteoinductive signal, and osteogenic cells.

Today, autograft bone is one of the most commonly used processes for bone grafting, and is often considered the traditional gold standard, containing all three components mentioned above. The Trinity ELITE and the Trinity Evolution allografts are both human donor bone grafts that contain a viable cancellous and a demineralized bone component, which also includes adult human mesenchymal cells and osteoprogenitor cells (MSCs and OPCs). These are retained within the cancellous bone matrix.

In a study conducted by a group of a members from New York University, SRM University in India, Orthofix, Inc., and the Department of Neurosurgery from the Mayo Clinic in Phoenix, Arizona, marker proteins and gene expressions were tested in bone chips. This was done to test their osteogenic and therapeutic abilities. Four different donor batches were tested, which were thawed and homogenized, then centrifuged using an RNA solution. For comparison, cultures of bone marrow cells (BMCs) derived from both human marrow and other Trinity Evolution samples were used.

The RNA isolation techniques implemented yielded great amounts of RNA for the analysis. The subsequent findings showed that the RNAs associated with MSCs and other bone-forming cells flourished at high to intermediate levels in both the Trinity ELITE and Trinity Evolution samples. For almost all of the genes tested, their levels of expression were either similar to or greater than cultures of BMCs.

In conclusion, both the Trinity ELITE and Trinity Evolution proved to have cell populations that exhibit high levels of gene expression with markers associated with MSCs, osteoprogenitors, and other bone-forming cells. Very low levels or no gene expression at all were shown with immunoreactive cells. This indicates that these cells did not flourish within the tissue, suggesting that this allogenic graft is much less likely to trigger an immune response.

These findings suggest that Trinity allografts possess material that contains an active osteogenic component that has the potential of contributing to bone healing in a clinical setting. Yet another finding that proves the efficiency and quality of Trinity products, and their high standards in the world of allografts and cell research.

 
For more on Orthofix products and allograft information in general, visit BennWillcox.net.

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