Treating Discogenic Back Pain with Bone Marrow Concentrate is Superior to Lumbar Disc Replacement at Two-Year Follow-up

Objective: Millions of patients suffer chronic back pain from degenerated lumbar discs.Surgical options for one or two levels of discogenic back pain are fusion or lumbar artificial disc replacement [LADR]. Study Design:This study compares the complications, reoperations, cost, and clinical outcomes of bone marrow concentrate [BMC] versus LADR for the treatment of discogenic back pain.The BMC study is prospective non-randomized class 2 data.The LADR studies were prospective randomized class 1 data.All operations were performed at the same private clinic.All studies had IRB approval.Follow up on all the studies was two years.Methods: The BMC was a 30-minute procedure involving aspiration of 55ml of bone marrow from the iliac wing, concentrating via centrifugation to a volume of 6ml and then injecting approximately 2ml of bone marrow concentrate per symptomatic lumbar disc.Clinical success in the LADR and BMC studies required a 50% improvement in ODI and VAS from pre-operative through two-year follow-up.Results: Clinical failure of LADR occurred in 27% (24 of 89 patients) at two-year follow-up.Five patients in the BMC study had surgery within two years of the BMC injection and were considered failures (19%).The remaining 21 BMC patients improved an average of 64% in ODI and 72% in VAS.Conclusions: These results indicate a BMC injection may be a reasonable non-surgical option for patients with symptomatic discogenic back pain.