Dr. Calodney and Dr. Chang Chien have an informative conversation over the use of regenerative medicine. They both agree that the reliance of corticosteroids in pain medicine may not be the best option for long term, chronic pain, as these continuous steroid injections can actually be catabolic to the surrounding tissues. Dr. Chang Chien talks about current research that demonstrates the efficacy of platelet rich plasma over other commonly used injectants for OA. Dr. Calodney discusses the pros and cons for these regenerative options for degenerative disc disease.

Richard Rosenthal, MD, discusses allogenic cell therapy. The Food and Drug Administration (FDA) has not approved the injection of live cells in patients due to concerns about transmission or disease and uncontrolled cell growth. Instead, acellular methods such as injecting amniotic fluid or exosomes produced by mesenchymal stem cells can be used. These fluids come from donors and contain growth factors and matrix-building proteins that have regenerative effects.

Dr. Ramsin Benyamin gives a brief talk on osteoporotic fractures and how he has focused his practice in preventing these atraumatic fractures. He explains how the consequences of such fractures can be life altering. He also discusses bone density preservation and the proper treatment for such fractures, including vertebroplasty and kyphoplasty.

Dr. Vallejo discusses the evolution of spinal cord stimulation (SCS) over the past ten years. This includes how the theory of its method of action has changed and new data on high frequency stimulation. He compares different SCS systems in terms of efficacy and patient compliance. He details how tonic and high frequency stimulation differ at the cellular level, detailing neurotransmitter release and “membrane integration”, and how improvements for SCS in the future will continue.