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

Abstrak

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 from 0.71 cells/mL to

151.59 cells/mL after leukapheresis, and mesenchymal stem cells increased from 0.0029 cells/mL to 0.0095 cells/mL. At 24 weeks post-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.