Low Back Pain: Disc Decompression Combined with Body's Own Fat Tissue
P. Grossi, S. Giarratana, S. Cernei, S. Grossi, F.M. Doniselli · unknown · 2016
Patient Reports Major Pain Relief Immediately After Procedure
A 43-year-old man with severe chronic low back pain underwent a new combined treatment. His pain came from a damaged disc between his third and fourth lumbar vertebrae. Before treatment, he struggled with basic daily activities. Even simple tasks like tying his shoes caused significant discomfort. Pain medications provided little relief.
The treatment combined two approaches in one procedure:
Nucleoplasty: A minimally invasive technique to decompress the damaged disc
Lipogems® injection: Specially processed fat tissue from the patient's own body
Right after the procedure, the patient noticed a significant decrease in pain. The numbness and tingling in his left leg also disappeared completely.
Disability Drops from "Severe" to "Minimal" at Six Months
Doctors measured the patient's disability using a standard questionnaire called the ODI (Oswestry Disability Index). This tool rates how much back pain affects daily life.
The results showed remarkable improvement:
Before treatment: 46% disability score (classified as "severe")
Six months later: 24% disability score (classified as "minimal")
This means the patient went from being severely limited by his back pain to experiencing only minor restrictions in his daily activities.
MRI Scans Show Physical Changes in the Treated Disc
The treatment didn't just reduce symptoms. Imaging showed actual changes in the disc itself. At six months, the MRI revealed two important findings:
First, the treated disc showed successful decompression. Second, doctors observed increased signal intensity in the disc's center. In simpler terms, this suggests improved hydration and health of the disc tissue. Before treatment, the MRI had shown a dehydrated, shrunken disc.
Procedure Takes Under One Hour with Local Anesthesia
The entire treatment was completed in about 45 minutes. The patient remained awake throughout, receiving only light sedation and local numbing medication.
Here's how the procedure worked:
Fat tissue collection: Doctors harvested about 40 cc (roughly three tablespoons) of fat from the patient's body using a small needle
Lipogems® processing: The fat was processed in a closed system for 15 to 20 minutes, creating micro-fragmented tissue without chemicals or enzymes
Disc treatment: Using X-ray guidance, doctors inserted a tiny instrument to remove a small portion of the damaged disc center
Nerve treatment: A radiofrequency probe was used to reduce pain signals from nerve endings
Injection: Two milliliters of the processed fat tissue was placed into the created space
Why Fat Tissue May Help Heal Damaged Discs
Current treatments for disc problems focus on relieving symptoms. They cannot repair damage or stop ongoing degeneration. This creates a need for new approaches.
Fat tissue contains mesenchymal stem cells (MSCs)—regenerative cells that can develop into various tissue types. Unlike other cell sources, fat tissue is abundant, easy to access, and simple to collect. The Lipogems® system preserves these cells in their natural environment without chemical processing.
The researchers explain that disc degeneration occurs when the number of healthy cells in the disc center decreases. By introducing regenerative cells from processed fat tissue, the treatment aims to support natural healing processes rather than just mask symptoms.
Single Case Shows Promise for Larger Studies
The authors acknowledge this report describes just one patient. However, they note it is part of a larger ongoing study. The combination of reduced disability scores and visible MRI improvements suggests this approach deserves further investigation.
For patients with disc-related low back pain who haven't responded well to standard treatments, this combined procedure offers a minimally invasive option. It uses the body's own tissue, requires no general anesthesia, and showed meaningful results that lasted at least six months in this case.
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Source: Grossi et al., unknown, 2016.
Original Publication
Low back pain treated with disc decompression and autologous microfragmented adipose tissue: a case report
P. Grossi, S. Giarratana, S. Cernei, S. Grossi, F.M. Doniselli · unknown · 2016
Background: Pathologies affecting the vertebral disk are extremely common in western industrialized countries. Although the causes can be multiple, it has been demonstrated that this disorder is associated with a degeneration of the intervertebral disk. Current therapies are focused on the relief of the symptoms but cannot repair the damage nor stop the degenerative process. Recently, new strategies for the regeneration of the intervertebral disk, such as the use of mesenchymal stem cells, have been identified. Objective: To evaluate the efficacy and potential benefits of using autologous, micro-fragmented and minimally manipulated adipose tissue graft (Lipogems®) associated with nucleoplasty for the decompression of the disk in a patient suffering for recurrent low back pain. Materials and Methods: Micro-fragmented adipose tissue was obtained using a minimal manipulation technique in a closed system (Lipogems®), without the addition of enzymes or any other additives. Under radioscopic control and with Seldinger technique a minimal part of the nucleus pulposus was emptied to reduce excessive compression level inside the disk, thus creating a virtual cavity. With a specific instrument, manually rotated at 360°, heat ablation of terminal nerve fibers with a radiofrequency probe was performed. At the end, autologous micro-fragmented adipose tissue was injected into the cavity. Results: In the immediate post injection period, the patient reported a significant decrease in pain and the disappearance of the paresthesia at the left lower limb. The ODI score at 6 months revealed a decrease of the disability, switching from 46% at baseline to 24%, i.e. from 'severe' to 'minimal'. The MRI at 6 months revealed a decompression of the treated disk and an increase in the signal intensity of the T2 sequences at the level of the nucleus pulposus. Conclusions: Although this is a single case report, part of a larger study, the results are very encouraging. The decrease of the ODI score and the decompression of the disk shown by the MRI gave evidence of the efficacy and potential benefits of using micro-fragmented, autologous, and minimally manipulated adipose tissue associated with nucleoplasty for the decompression of the disk.