Regenerative Medicine for Craniocervical Instability

When a patient has an injury of the cervical spine for quite a long time and/or in cases of Connective Tissue Disorders, conservative treatment may be not sufficient.

Because ligaments are too weak, muscles tend to tense up in order to compensate, so they get exhausted. For some patients therapies such as Physical Therapy can work counterproductive as you try to make the muscles stronger while they are overworked. This means muscles get even more exhausted and patients get worse.

In these cases when a patient can’t tolerate conservative treatment, it is better to strengthen ligaments. This can be done by Regenerative Medicine, where joints get injected with dextrose, blood platelets or stem cells. It is been said ligaments can’t heal, but Regenerative Medicine has been successfully applied in for example knees, hip joints and elbows. It can also be applied in the cervical spine. Although it is still an investigational method, the results are – depending on each patients’ background – hopeful and many patients feel better after a few procedures. However, Regenerative Medicine is very expensive, not covered by insurances and thus financially impossible for the vast majority of patients, so they unfortunately remain dysfunctional or even bedbound. 


In Prolotherapy joints are injected with dextrose. It promotes an inflammatory response of the injected ligaments, the body will try to heal the inflammation and ligaments will be strengthened. It has been applied for many years for joints such as knees and elbows. It can also be applied in the cervical spine, where posterior capsule ligaments are injected.

Platelet-Rich Plasma (PRP)

PRP is the injection of concentrated platelets (5-6x the concentration in the blood) releases growth factors to stimulate recovery in non-healing soft tissue injuries. It is injected in posterior capsule ligaments and surrounding muscles. The goal is to heal posterior ligaments and thus to create more stability. A few weeks after the procedure it is recommended to start doing light exercises. 


    Posterior Stem cell & PICL

    If PRP fails, patients can try Posterior Stem Cell therapy, where stem cells are injected in posterior ligaments by using your own bone marrow. If anterior ligament damage is primarily causing instability, PICL can be useful. In PICL stem cells are injected in the anterior ligaments. Please note stem cell therapy is still an investigational method, but so far there are good results and it can prevent patients from getting surgery. 

    Please watch this video from dr. Centeno from the Centeno-Schultz clinic and learn more about regenerative stem cell procedures for Craniocervical Instability.