Regenexx first began treating injured nerves using orthobiologics delivered via ultrasound guidance in 2012. At that time, the concept that a precise injection could help nerve regeneration was revolutionary. After a few years of seeing nerve- injury patients consistently respond to this therapy, it’s time for Regenexx to share some of our results and finally declare our confidence in this new procedure that may change how doctors treat nerve injury and entrapment.
Regenexx’s history with nerve regeneration begins with a different take on platelet-rich plasma. Platelet lysate is made up of the healing growth factors isolated from platelets and suspended in a cytokine-rich serum. Its anti-inflammatory qualities means that it works particularly well around nerves. Regenexx doctors have been using platelet lysate in the epidural (spinal column) space since around 2007 with great results, mostly for patients with sciatica (radiculopathy). Success with platelet lysate led to the creation of successively more powerful versions of platelet lysate.
A critical part of the Regenexx nerve-regeneration procedure is precise ultrasound-guided hydrodissection. This involves using a small needle to inject small amounts of platelet lysate around the nerve. This effectively breaks up scar tissue around the nerve. Scarring around the nerve often is involved in nerve entrapments. Think of a garden hose and how the water flows through it. A nerve transports nutrients down its length in a similar fashion. If you step on the garden hose, less water comes out the end, and a nerve that’s entrapped and scarred acts in a similar way. Hydrodissection is like releasing that pressure on the garden hose.
Growth factors in platelet lysate can help nerve function as well. One of those natural compounds is called vascular endothelial growth factor (VEGF) and is responsible for causing the body to create new blood vessels. Nerves have a blood supply like any other tissue. When pressure is placed on the nerves, that blood supply can be cut off, reducing oxygen to the nerve. Creating new blood vessels around nerves may be important in nerve regeneration.
Surgery to get rid of nerve entrapment generally is not a good idea. Many patients have gone through these surgeries with no results, or have developed new problems related to the surgery. Research has shown that one of the world’s most common nerve-entrapment-release surgeries, carpal tunnel release, destabilizes the bones of the wrist by cutting a critical ligament.
Trying to repair nerves by cutting them and splicing them back together with micro-surgery is notoriously difficult. Getting this surgery just right is hit-or-miss. The better option well may be to free up some space around the nerve and give growth factors the opportunity to help the nerve accomplish its own regeneration.
Regenexx procedures have been observed time and time again to eliminate carpal tunnel syndrome (entrapment of the median nerve at the wrist) without surgery. Regenexx procedures have helped a patient regain radial nerve function, and they’ve been used to treat ulnar nerve encampments at the elbow, femoral nerve entrapment at the thigh, and tarsal tunnel at the ankle. All without the need for invasive surgery.
NOTE: Regenexx Procedures are designed to help nerves that have been injured or have become entrapped. Nerves that are cut in half with large gaps are likely too severe for this procedure.
“Nerve Regeneration—The Future Doesn’t Involve Surgery” first appeared as a post on the Regenexx blog.
Like all medical procedures, Regenexx procedures have a success and failure rate.
Not all patients will experience the same results.