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View Full Version : Installment 16 - 10 Questions with Dr. John R. Schultz



Technocracy
03-05-2009, 08:58 PM
This month?s Ask the Doctor column is being hosted by Dr. John R. Schultz

As always a big round of thank yous from our community members to our hosts / contributors.


About the Doctor

Dr. John R. Schultz trained at George Washington University in Washington, D.C. before specializing in Anesthesiology and pain management. He is currently the Co-Medical Director at The Centeno-Schultz Clinic, in Westminster, Colorado.

The Centeno-Schultz Integrative Pain Management Clinic offers a full range of services and the latest treatment options for the diagnosis and treatment of acute and chronic pain.

We are a research based, integrative pain management clinic. This means that we offer the best of traditional medicine and aren't afraid to use alternative techniques that make sense. Our Integrative pain management approach involves finding the common thread among diverse systems of treatment, following and creating the latest developments in the peer reviewed medical literature, and taking the best of each to help patients reduce their pain and increase their function

Dr. Schultz also has a blog at www.stemcelldoc.wordpress.com (http://www.stemcelldoc.wordpress.com) with some further information of interest.



1) My son suffers from cervical spondylosis and has been on pain killers, received cortisone shots, and yet the pain is still unbearable. He is 39 years old, average weight/height, no health problems, exercises, doesn't drink or smoke. Would your treatment be beneficial to him?

Cervical spondylosis is a common degenerative condition of the cervical spine. It is thought to be caused by age-related changes in the intervertebral disks. Some authors also include the degenerative changes in the facet joints, longitudinal ligaments, and ligamentum flavum.

The key to treating your son?s pain is to identify the pain generator. This is the cornerstone of our interventional practice at the Centeno-Schultz Clinic. We inject under x-ray 1-2cc of local anesthetic into a given structure in an attempt to identify the source of a given patient?s pain. Possible pain generators include the facet joints, ligaments and the cervical disc.

We are starting to investigate the role of mesenchymal stem cell therapy for cervical facet dysfunction. At this point in time our experience in treating degenerative disc disease is limited to the lumbar spine.



2) After stem cells have been applied to a joint, would subsequent continuing injections of Somatotropin (Human Growth Hormone) into the joint space be expected to enhance the regeneration effects of the stem cells?

We do not use HGH in any of our protocols. Some patients however do return for subsequent treatments where we inject additional stem cells. Regenexx has a state of the art lab which enables patients to freeze stem cells to be used at a later date.



3) Would one expect to see the stem cell treatment help other parts of the body as well as the main orthopedic problem or do you somehow get the cells to only home into the joint or whatever area you are targeting?

The stem cells that are injected are targeted for a specific area and do not migrate to other parts of the body.


4) Can autologous stem cell therapy exert its regenerative/restorative effect on eburnated bone, or does the eburnation need to be removed?

Eburnation occurs when the cartilage has been worn away (by osteoarthritis); the bone surface evolves an eggshell-thin layer of highly polished (as might be expected!) dead bone, which acts like a contact layer of sorts.

According to Webster, eburnation is a condition of bone cartilage occurring in certain diseases of these tissues, in which they acquire an unnatural density, and come to resemble ivory. There have been significant improvements in MRI technology which have enabled us to visualize cartilage which previously was not detected. Specifically the use of a 3.0 Telsa MRI affords 2-3 times the resolution of conventional MRIs.

A special sequence has enhanced our ability to see cartilage. It is termed Fast Spoiled Gradient Recall Echo (FSGR). If cartilage is present autologus mesenchymal stem cell therapy may be a treatment option depending upon the severity of cartilage loss.



5) Do you know of the work being done by Dr. Allan R. Dunn in North Miami, Florida? Dr. Dunn has been successful in regenerating synovial joint cartilage and bone in patients using direct injections of Somatotropin (Human Growth Hormone) into the joint space.

Yes I am aware of the work performed by Dr. Dunn, but we do not utilize any HGH in any of our protocols.



6) Is the type of treatments you are giving becoming routine for sports figures? Can you tell us a little about your work in that area?

Many professional athletes are using the healing potential of their own cells as witnessed by the two Pittsburgh Steelers? players who platelet rich plasma (PRP) injections into the damaged knee tissue. The team physician, Dr. Joseph Maroon, a neurosurgeon, underwent stem therapy at Regenexx which enabled him to complete the Ironman Triathlon as detailed on our website. Due to patient confidentiality, I am unable to comment on our treatment of professional athletes.



7) Do you need to do a booster stem cell treatment after the initial treatment for the knee?

In all the large joint applications, we are using a layering technique whereby the total number of stem cells is divided into three equal injections. The patient undergoes therapy once a month for three months thereby maximizing the opportunity for successful cartilage regeneration. If there are cells available upon completion of therapy, a given patient may return for additional injections of stem cells if significant progress or reduction of pain has not been realized.



8) If the stem cells from the older person (75+ years) are considered to possibly not be well usable for stem cell therapy for joint restoration, are there any current procedures for revitalizing those stem cells after extraction from the patient?

At present there are no procedures for revitalizing stem cells. Our two oldest patients have been 82 and 88 years old respectively and have had good outcomes. Chronologic age is not the only factor that plays a role in the vitality of the stem cells. Other issues include current medications, concomitant medical conditions and level of active exercise.


9) What are the current methods of assuring that direct placement of stem cells into the joint space, remain in close proximity to the target sites?

In general terms the best way to keep the cells within the joint space is to limit the volume of cells injected and inject contrast (dye) prior to ensure accurate placement of the cells.



10) I broke 3 toes on my left toe many years ago. Sometimes, when I first wake up and stretch a bit in bed, they almost lock up like a Charley Horse and the pain is horrible. Would a shot of stem cells in the toes help with this? Is this something we will see in the future for our aches and pains?

Painful muscle tightening is indicative of muscle dysfunction. At the Centeno-Schultz Clinic we use intra-muscular stimulation to restore normal muscle function. While we are blessed with the knowledge and capability of using stem cell therapy, we are committed to evaluating the musculoskeletal integrity of each patient.

If there is an imbalance in posture, gait or muscle activity this needs to be addressed and corrected prior to any additional therapy. So is the muscle tightness and pain due to muscle dysfunction or damage to the left toe joints? Examination is the only means by which to answer this question.

Should the pain arise from a damaged joint, we have utilized mesenchymal stem cell therapy to improve joint function and reduce pain.


About the Company

The Centeno-Schultz Integrative Pain Management Clinic offers a full range of services and the latest treatment options for the diagnosis and treatment of acute and chronic pain.

We are a research based, integrative pain management clinic. This means that we offer the best of traditional medicine and aren't afraid to use alternative techniques that make sense. Our Integrative pain management approach involves finding the common thread among diverse systems of treatment, following and creating the latest developments in the peer reviewed medical literature, and taking the best of each to help patients reduce their pain and increase their function.

www.regenexx.com (http://www.regenexx.com)

1-888-525-3005