Chronic Lumbar Radiculopathy Treated With Autologous Peripheral Blood Stem Cells: A Case Report

Abstract

Background : Lumbar radiculopathy may arise from the compression of
lumbosacral nerve roots, leading to pain and disability. We report a case
of chronic lumbar radiculopathy that was successfully treated with
peripheral blood stem cells over 24 weeks.
Case Presentation : A 62-year-old woman with sharp pain in the back,
radiating to both lower legs. Her pain became intense when she was
walking about 200 meters, and has been happening for 2 years. She fell
and hit her back 7 years ago, and refused to undergo spine surgery in a
hospital. Magnetic resonance imaging revealed facet joint hypertrophy
and thickening of the ligamentum flavum at L3/L4, L4/L5, and narrowing
of the spinal canal. The pretreatment numerical pain rating (NPR) score
was 7 (out of 10), and the Oswestry Disability Index (ODI) for low back
pain was 19 or 38% (19/50 x100%). She was administered a 5-day course
of granulocyte colony-stimulating factor (G-CSF, 5mg/kg/day)
subcutaneously, followed by leukapheresis on the fifth day. Circulating
and intravenous infusion of autologous peripheral blood stem cells were
analyzed using flow cytometry. She also received transforaminal injections
of 3 ml of peripheral blood stem cells (PBSCs) at each affected lumbar
level. Peripheral blood CD34+ cells increased fro
-
treatment, the percentage reductions in pain and ODI were 100% and
79.0%, respectively. There were no serious adverse effects from the
procedure.
Conclusion: Autologous peripheral blood stem cells are an effective
treatment for chronic lumbar radiculopathy.
Keywords : lumbar radiculopathy, peripheral blood stem cells, spinal
stenosis, granulocyte colony-stimulating factor, leukapheresis