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There has been a lot of news lately about the use of stem cells to treat and possibly cure various diseases, including heart disease, diabetes, Parkinson's and one of the most common of medical conditions, lower back pain.

There are now many different medical facilities, from top medical centers to your local medical clinics, offering stem cell treatment. Often times, these treatment are not covered by medical insurance and therefore patients who want these treatments have to pay out of pocket. These costs range from a few hundred dollars to thousands of dollars.

This is uncharted territory since there is little real clinical data to prove if the use of stems cells is effective as advertised.

So what are stems cells? Stem cells are a certain type of cells in our bodies which have the ability to divide and to become other types of cells. Think of stem cells in the same that a baby can grow up to become anything, such as a firefighter, lawyer, teacher, etc.

In much the same way, stem cells can "grow up" to become a tendon cell, a joint cell, a heart cell, a lumbar disc cell, etc. As such there has been great interest in using stems cells' ability to differentiate to treat and possibly cure many types of diseases where the original cells are injured or damaged.

Stem cells can be derived from two main sources; adult stems cells or embryonic stem cells. Adult stem cells are found in certain tissues, such as fat and bone marrow. Embryonic stem cells are, as the name implies, derived from embryos, which, given their source, can be difficult to obtain.

Embryonic stem cells show more ability than adult stems cells to differentiate into various cells. However, due to the difficulty in obtaining embryonic stem cells and the risk of cell rejection, autologous adult stems cells are more attractive to be used.

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Stem cells are rare. In fat tissue, the population of stem cells is one stem cell out of 2,000 cells. They are even rarer in bone marrow where they are one stem cell out of 10,000 to 20,000 cells.

When used to treat blood disorders, stem cells are harvested from the bone marrow and grown to expand the number of cells before they are re-injected into the patient after the patient’s damage blood cells are killed with chemotherapy. The harvested stem cells are used to replace the blood cells.

For novel uses of stems cells to treat diseases such as Parkinson's and back pain, the details are not as well sorted out. In fact, the use of stem cells in these condition is not necessarily FDA approved, as most patients believe.

The FDA has not given blanket approval for the use of stem cells but rather has given a set of rules or exceptions for the use of stem cells. Most clinics or medical facilities that promote stem cells use have to follow these FDA exceptions to be compliant.

One of these rules includes that the stems cells cannot be expanded once they are harvested from the patient. Since this limits the amount of cell that can be injected into the patient, most facilities have resorted to using embryonic stem cells, which come in a pre-determined amount.

However, although the amount of stem cells are determined with each injection, what is not clearly defined is what is the right amount of stem cells needed to treat certain conditions, such as low back pain. This we will explore in part 2.

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Dr. Dwight S. Tyndall, FAAOS, is a minimally invasive spine surgeon practicing in the Region at DrSpine.com. His column, which appears every other week, covers a wide range of health and medical issues.

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