Safety and Feasibility of Intradiscal Autologous Bone Marrow Aspirate Concentrate at the Time of Lumbar Microdiscectomy: A Prospective Pilot Study.
Academic Article
Overview
abstract
BACKGROUND: Lumbar microdiscectomy improves pain and disability but does not restore disc biology, and same-site recurrence can occur. Intradiscal autologous bone marrow aspirate concentrate (BMAC) has growing preclinical support, but human safety data are limited. OBJECTIVE: To evaluate intradiscal BMAC safety and feasibility at lumbar microdiscectomy. METHODS: Patients underwent lumbar microdiscectomy and 1 mL intradiscal autologous BMAC with 1-year follow-up. Primary outcomes were procedure-related complications, readmissions, reoperations, and same-site recurrence; secondary outcomes were Oswestry Disability Index (ODI) and Numeric Rating Scale (NRS) for leg and back pain; exploratory quantitative magnetic resonance imaging (MRI; T1-rho, T2) screened for adverse compositional changes. RESULTS: 27 adults underwent lumbar microdiscectomy with concurrent intradiscal BMAC injections. No intraoperative or postoperative injection-related complications occurred. Same-site recurrence occurred in 1/27 (3.7%) and was managed without reoperation. Patient-reported outcome measures (PROMs) were completed by 18/27 (67%), and qMRI was obtained in 16, including 6 with complete imaging through 1 year. Among patients with completed PROMs, mean ODI, NRS-leg, and NRS-back improved at 1 year, but the uncontrolled design precludes efficacy inference. No adverse changes in T1-rho or T2 were observed through 1 year. CONCLUSIONS: In this single-center prospective pilot, intradiscal BMAC at the time of microdiscectomy was safe and feasible, with no injection-related harm through 1 year and one same-site recurrence. Without a control group and with incomplete follow-up, findings are preliminary safety data, not evidence of efficacy or reduced recurrence risk. These results support a multicenter study with longer follow-up and a controlled comparison group.
