1. What are Stem Cells?
  2. What are autologous adult stem cells?
  3. How do adult stem cells work?
  4. What conditions are most helped by Stem Cell Therapy?
  5. Are there any known side effects to Adult Stem Cell Therapy?
  6. How long is the procedure?
  7. How long will it be before I see results?
  8. Is the procedure FDA approved?
  9. Are there any moral issues associated with Adult Stem Cell Therapy?
  10. Where is the best source of stem cells for therapy and treatment?
  11. Do you offer Bone Marrow Harvesting?
  12. What is Regenerative Medicine?
  13. Can Stem Cells cause cancer?
  14. Can Stem Cells be used in patients that have or have had cancer?
  15. How are Stem Cells administered to the patient?
  16. What claims are you currently making about what stem cell therapy can do for you?
  17. Is anything added to the stem cells?
  18. Does a patient have to participate in an IRB study and does a patient have to qualify for the IRB study to get treatment?

What are Stem Cells?
Stem cells are unspecialized cells but can give rise to almost any type of specialized cell in the human body. The environment in which the stem cell finds itself determines what kind of specialized cell the stem cell will become. In the example of placing the stem cells inside of a disc during our Stem Cell Therapy, they turn into cells that will rebuild the disc. PM&R Associates uses adult stem cells that only have the ability to turn into tissues, such as cartilage and connective tissue, as is found in spinal discs and joints, tendons, muscle, and ligaments. All of these tissues can be repaired with stem cells and to a lesser extent platelets. The cells are taken from your own body and used for treatment the same day, so there is no risk of rejection or disease transmission. All Stem Cell Treatments are performed in our clinic, under conscious sedation and local anesthesia. This procedure is not currently covered by any insurance company.

What are autologous adult stem cells?
Autologous adult stem cells are derived from the same individual’s body. Adult stem cells are undifferentiated cells, found throughout the body after development and do not have many of the properties of embryonic stem cells that, as the name implies, come from the embryo. Although adult stem cells can form other cells, they cannot form a new person and are not associated with the kind of cancers associated with embryonic stem cells. Stem cells are the fundamental elements of life that can be found in all tissues of the body: connective tissues, muscle tissues, nervous tissues, and epithelial tissues. In living tissue, adipose (fat) tissue has the highest concentration of stem cells and can produce billions of cells that will repair, replenish, and rejuvenate one’s body immediately.

How do adult stem cells work?
Adult stem cells are undifferentiated cells, found throughout the human body, that form after growth & development. The main purpose of adult stem cells is to use cell division to repair and replace dying cells in order to regenerate damaged tissue. Once adult stem cells are administered to the body, they respond to inflammatory signals secreted by damaged cells.

What conditions are most helped by Stem Cell Therapy?
Although many clinics use stem cells to treat a wide variety of systemic conditions, at PM&R Associates we only treat musculoskeletal (MSK) conditions. These are primarily degenerative disc disease and osteoarthritis. Other MSK conditions would also respond, but usually less costly alternatives exist.

Are there any known side effects to adult Stem Cell Therapy?
Side effects from stem cell therapy are related to the harvesting of the tissues that provide the stem cells, and the procedure itself, not the stem cells. This is true as long as all of the blood cells are removed from the stem cells because the blood cells produce the pain associated with stem cell therapy. All of the cells can be removed from adipose derived stem cells but not from bone marrow derived stem cells.

How long is the procedure?
Both the liposuction and bone marrow aspiration take about 30 minutes. Processing the adipose tissue takes about 40 minutes and the disc injection procedure takes between 30 and 45 minutes. A joint injection takes only a few minutes. You will be in the clinic about 2 hours, but we ask you to plan 3 hours in case there are unforeseen complications.

How long will it be before I see results?
Stem Cell Therapy is a biologic treatment. It takes time for the biologic response to take effect, so the longer you wait, the better the result. We do not expect to see significant results before two months.

Is the procedure FDA approved?
No stem cell therapy is FDA approved, even the use of stem cells to treat certain forms of cancer. The FDA has decided that they will not interfere as long as the stem cells are not altered and are used the same day. Not altered means the stem cells cannot be cultured to increase their numbers. By using adipose (fat) tissue as the source, enough stem cells are obtained so that culturing is not necessary.

Are there any moral issues associated with Adult Stem Cell Therapy?
The controversies associated with stem cell therapy are associated with embryonic stem cells. Stem Cells used during treatment come from your own body. PM&R Associates does not harvest embryonic stem cells and is therefore not related to any controversial debates.

Where is the best source of stem cells for therapy and treatment?
About 50,000 stem cells are harvested with a bone marrow aspiration. Of these only 50 to 500 are of the type that can repair musculoskeletal (MSK) tissues: disc wall, joint cartilage, tendon, ligament, and muscle. Another source of stem cells is peripheral blood. Only about 5,000 stem cells of the type that can repair MSK tissues are obtained at one time. About 5 million (5,000,000) stem cells are harvested from fat at one time and almost all are of the type that can make MSK tissues. Since the numbers are so large, there is no need to increase their numbers by culturing and the cells can be used the same day.

Do you offer Bone Marrow Harvesting?
We have and can do bone marrow harvesting, but since it is more painful and results in less stem cells of the type we want, there would have to be a compelling reason to do so.

What is Regenerative Medicine?
Regenerative medicine is the “process of replacing or regenerating human cells, tissues or organs to restore or establish normal function”. This field holds the promise of regenerating damaged tissues and organs in the body by replacing damaged tissue and/or by stimulating the body’s own repair mechanisms to heal previously irreparable tissues or organs. See Regenerative Medicine.

Can Stem Cells Cause Cancer?
Adult mesenchymal stem cells are not known to cause any type of cancer. You may have heard stories of cancer caused by stem cells, but these are related to the use of embryonic stem cells, not Adult Mesenchymal Stem Cells. These embryonic tumors are called teratomas and may occur when embryonic stem cells are used.

Can Stem Cells Be Used in Patients that have or have had Cancer?
Stem cell therapy is generally thought to be safe for patients with dormant cancers. If someone has had cancer in the past and was successfully treated, there is no reason to withhold stem cell therapy. In most cases, stem cells should not be used in patients with active cancer.

How are Stem Cells Administered to the Patient?
In our clinic, stem cells are only administered by injection into the spinal disc or a peripheral joint. Some clinics give stem cells intravenously to treat conditions other than degenerative spinal disc disease or osteoarthritis. We are currently not treating those conditions.

What claims are you currently making about what stem cell therapy can do for you?
None. We are participants in an IRB (Institutional Review Board) study on the treatment of osteoarthritis of the knee and soon will be in an IRB study on degenerative disc disease. This will give us hard data about what stem cell treatments can do for you. The early results from the osteoarthritis study show improvement. Early results from this study show a 75% improvement in pain scores at six months post treatment. Other studies have shown improvement in both cartilage and meniscus size.

Is anything added to the stem cells?
Nothing is added except for platelet rich plasma derived from the patient’s own blood. This gives the therapeutic advantages of both treatments at the same time. PRP contains platelets, growth factors and fibrin, all of which have shown therapeutic effects.

Does a patient have to participate in an IRB study and does a patient have to qualify for the IRB study to get treatment?
No. There is no cost to the patient to participate, but it is not required if the patient does not wish to participate. If a patient does not qualify, but the patient and the doctor both feel they might benefit, they can go ahead with treatment. An example might be if they have more discs that are abnormal than the study protocol allows.