Performing outpatient PRP for spine — One ASC's 1st-time experience

In February, La Peer Surgery Center in Beverly Hills, Calif., became the site of one of the first stem cell lumbar intradiscal injection and platelet rich plasma therapy procedure performed in an outpatient setting. Orthopedic surgeon, Steven Meier, MD, performed the procedure on a patient who suffered from degenerative disc disease as well as chronic low back pain for an extended period of time.

"Stem cell and PRP spine injections are being performed in certain centers around the United States. However, this technology is certainly not in widespread use," says Dr. Meier. "As more clinical studies are performed and the roles of these therapies in the spine and extremities become better delineated, the use of biologics like these may become more commonplace."

Dr. Meier performs injections along the lumbar region of the spine, supplemented with PRP prolotherapy to supporting ligaments and the sacroiliac joint. PRP prolotherapy induces collagen production, which stimulates healing, ligament regeneration and recovery.

Dr. Meier, who provides care at La Peer Surgery Center, has expertise in preservation and restoration procedures. "Stem cell treatment replaces the old paradigm of living with the condition. Instead, the patient's worn-out discs will heal and rebuild and supporting ligaments will strengthen. Chronic pain and suffering is eliminated and replaced by improved mobility and range of motion," he said in a press release.

According to Dr. Meier, the ASC's clinical team was fairly well versed in intradiscal stem cell injections because they already had experience in performing various spinal injection therapies. Additionally, they had prior experience using PRP and stem cells for simple applications in peripheral joints. However, insurance companies don't currently cover the therapy, which was one of the biggest challenges.

"For patients interested in having these procedures, we do offer cash rates," added Dr. Meier.

The PRP market is expected to grow steadily over the next five years. A 2015 Transparency Market Research report found that the global PRP market was around $160 million in 2013 and is expected to grow to $350 million by 2020. The increasing number of orthopedic injuries, cosmetic surgeries and growing awareness of PRP are driving market growth. North America held more than 50 percent of the market share in 2013. Another market report by Global Industry Analysis notes that the market is dominated by Harvest Technologies, Biomet, Arthrex and Arteriocyte Medical System.

For ASCs are interested in adding PRP and stem cell therapies, there are a few considerations. According to Dr. Meier, the first step is to decide whether to maintain a full laboratory with a technician to process the specimens by hand or whether to opt for an automated system.

"Either way, it is important for the staff to be well-trained in the technical aspects of working with these biologics," he says.

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