Teacher’s Aid

Leading-edge treatment uses donor tissue to regenerate spinal joint.

Judy Rodman can’t remember a time when she didn’t want to be a teacher. She fulfilled her dream and taught reading, public speaking and drama for nearly 30 years. During her career, Judy worked with a wide spectrum of students of various ages, from sixth grade to university level.

“In Maryland, where I’m from, I taught high school in the inner city for four years,” Judy recalls. “Then I moved to Japan and served as a Department of Defense teacher for two years. In 1980, I moved to Atlanta and taught there until 2003, when I retired.”

There are many things Judy loved about teaching. She really cared about her students and focused on preparing them for the future.

“I saw my students as the potential citizens they were,” she relates. “My concerns were to make them the best citizens and the best people they could be. I did whatever I could to make them feel good about themselves, be successful and have happy lives.”

Judy has been living happily in Florida since 2006, but in the summer of 2017, severe low back pain interrupted that bliss. Judy doesn’t recall injuring her back. The pain came on suddenly, she says, and it was intense.

“It was a crushing pain that just grabbed me,” she describes. “It ran from the side of my left hip and traveled all the way down through my foot. I knew it wasn’t sciatica because I had that in the past and had surgery for it years ago. But it felt like sciatic pain.

“Walking and sitting were difficult because of the pain. I took a lot of anti-inflammatory medication, I had to use a walker to walk, and there were times when I was confined to bed. It made me question if I wanted to live this way.”

In addition to taking anti-inflammatories, Judy also tried acupuncture to ease her pain. It had helped her with pain in the past, but it didn’t work this time. A friend recommended she visit Sunil Panchal, MD, a board-certified interventional pain specialist, who is president and medical director of National Institute of Pain, which has centers in Lutz and Tampa.

“Judy came to us in August 2017 reporting pain in her lower back that radiated into her buttocks,” Dr. Panchal notes. “Diagnostic blocks suggested that most of her pain was coming from the joints of her lower back, mainly her sacroiliac joint.

“Judy expressed a strong interest in avoiding surgery. After a discussion, she opted to pursue regenerative medicine techniques.”

“Dr. Panchal listened to me, which was very important to me,” Judy shares. “He thoroughly explained the various treatment options available and the research he’s done on them. That’s one of the things I respect most about Dr. Panchal. He does a lot of research, so it’s not just, Hey, let’s try this. He really knows what he’s talking about.

“He initially treated me with various injections, and we discussed spinal fusion surgery as an option. Finally, we decided to try a growth factor injection. I had that procedure done in February 2018. By August, I felt better.”

Healing Cascade

There are various techniques within regenerative medicine, Dr. Panchal points out. Options include using platelet-rich plasma (PRP), which is taken from the patient’s own blood, and harvesting tissue from the patient’s bone marrow or fat. The harvested materials are then formulated into injections that are placed at the site of pain. There are drawbacks to these techniques, however.

“Our main interest is in obtaining growth factors, which trigger the healing cascade,” Dr. Panchal describes. “But when material is harvested from the patient’s blood, bone marrow or fat, there’s actually a very small percentage of the material that contains the stem cells that produce growth factors.

“There’s also no way of predicting how many of the patient’s stem cells will survive the transfer process, become functional and produce growth factors. Harvesting a patient’s own tissue requires another, separate procedure, which increases time and costs. And the harvesting procedure can leave the patient with residual pain at the harvest site.”

In addition, it takes approximately six months for the patient to see any results using that method, and the failure rate is high, especially in older individuals, because the amount of viable material is low. There’s another regenerative medicine technique, however, that bypasses these drawbacks.

“That option is an allograft, which uses donor tissue from human amniotic membranes,” Dr. Panchal informs. “Amniotic tissue has a very high concentration of growth factors, as well as a greater variety of growth factors. Using this method, we essentially deliver growth factors directly to the patient’s area of need, so results occur more quickly.”

Allograft rejection is not an issue because amniotic tissue is acellular. There are no cells in it, so there are no antigens to trigger an immune response. Dr. Panchal used an allograft to treat Judy’s back pain.

“We injected it into the anterior and posterior sides of the sacroiliac joint,” the doctor explains. “The anterior side was treated previously with injections and radiofrequency ablation, which gave Judy temporary relief, but the posterior side was never treated.

“After receiving her allograft, Judy reported some pain relief at three and a half months post-injection. By the six-month mark, she had one hundred percent relief from her pain.”

Recommended for Relief

Judy confirms Dr. Panchal’s report of her results from the allograft injections.

“About three and a half months afterward, I noticed the pain was not as crushing, but I was still using a walker and taking pain meds,” she describes. “At about four months, there was a little less pain, and by six months, it was gone.

“Now, I can walk, run and dance, and I actively volunteer. People forget about those things when they don’t have their health. And I’ve been doing a lot of traveling internationally, and it’s nice not to worry if there will be steps or if I’ll be able to stand and walk.”

Judy says she recommends the allograft procedure to others, but she’s quick to qualify her recommendation.

“I only recommend it if it’s done by a physician who’s trained in the procedure, such as Dr. Panchal,” she says. “My procedure was successful because I went through a trained expert in the field who gave me different options and explained the effects of each of them, including surgery.

“I absolutely recommend Dr. Panchal. He listened to me and gave me the time I needed, and he does his research. He obviously did it for me because I feel fine now. Thank you, Dr. Panchal!”

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    • National Institute of Pain

      We treat each patient individually, using the latest equipment and various innovative procedures to diagnose pain and determine your care needs. We then assemble the appropriate interdisciplinary team of health care professionals who can best... Read More

    • Sunil J. Panchal, MD

      Sunil J. Panchal, MD, is board certified by the American Board of Anesthesiology in interventional pain medicine. He earned his Bachelor’s degree in Biology from Rensselaer Polytechnic Institute in Troy, NY, and earned his medical degree from... Read More