Post-injection Guidelines

IDAOBI: IntraDiscal Autologous OrthoBiologic Injection

¨ WHAT IS IDAOBI?

IDAOBI is a procedure aimed at doing two things: reducing pain from a damaged intervertebral disc and diminishing the rate of (and possibly also reversing) degeneration of the disc. First we either sterilely draw your own blood, or sterilely withdraw your bone marrow for concentration and selection of cells.

Then, in the clean room, and after numbing with either Lidocaine, Marcaine or both, an 1/8th inch working incision is made. We then we use stereotactic X-ray guidance to place a thin delivery needle within the treatment discs and deliver your own selected cells and cytokines to the disc(s).

¨ WHICH PATIENTS ARE CANDIDATES FOR IDAOBI?

You have highly suspicious discs on MRI and/or CT, that fit the protocol criteria. You may have failed facet blocks, ablation or epidurals, you would like to avoid back surgery for the disc problem. There is a reasonable suspicion that IDAOBI might help alleviate pain, or change, possibly halt or reverse degeneration. You have no recent infections. You’re off blood thinners for a week or better or as guided by your physician.

¨ WHAT ARE THE RISKS OR SIDE-EFFECTS WITH IDAOBI?

The main (but not only) associated risks involved with the injection(s) and placement of the needle are bleeding, infection, and damage to a nerve or spinal cord or lung, and of course failure of the procedure to work. The procedure is performed under sterile conditions with the use of direct x-ray guidance which reduces the probability of the associated risks.

During the procedure you will be given an antibiotic prophylactically and be asked to report any signs of a developing infection such as redness, swelling and drainage at the injection site. You will be asked to report any increases in your temperature. You should have a thermometer at your home to report these changes to the team.

· IF YOU ARE ALLERGIC TO IV DYE, OR ANTIBIOTICS YOU SHOULD REPORT THIS TO YOUR TEAM.

· POSTOPERATIVE GUIDELINES FOR IDAOBI for best outcomes…

o Wear a lumbar corset/back brace for 6-8 weeks after IOT

o Limit sitting for the first 6 weeks

§ First week: Sit no longer than 10 minutes then move around

§ Second week: Sit no longer than 20 minutes then move around

§ Third week: 30 min etc…

o Perform sedentary activity only for the first 10 days after the procedure

o Driving is prohibited for the first 5 days, then only 20-30 minutes at a time for the first 6 weeks.

o Riding as a passenger is acceptable for up to 45 minutes in a comfortable seat (move around and do pressure relief per the sitting protocol).

o Lifting limit is 10 pounds (a gallon of milk is 8 lbs) for the first 3 weeks

o Walk 20 minutes daily after the first week; advance to 20 minutes twice a day as tolerated

o Do stretching exercises for legs (gently) after first week.

o No NSAIDS (No aspirin, no advil, motrin, voltaren, Celebrex etc… x 4 weeks) Tylenol is OK

o No swimming in the first 3 weeks.

o Resume gradual activity on a graded program, with attention to back care, commencing at approximately 8 weeks as tolerated, supervised by a physical therapist if required.

Call the office if: Fever greater than 100.4 deg F, dramatically increasing back pain, or any neurologic changes.

Note: With PRP especially back pain may increase for the first several days before abating.