Vivek Babaria, DO, FAAPMR, is cautiously optimistic about what’s next for regenerative medicine, and as an interventional spine and sports medicine physician, he’s focused on the data that will drive it forward.
Dr. Babaria of DISC Sports & Spine Center, who sees patients in Newport Beach and San Diego, spoke with Becker’s about the opportunities ahead and where orthobiologics needs more leadership.
Note: This conversation was lightly edited for clarity.
Question: What interesting research have you done with regenerative medicine in spine care?
Dr. Vivek Babaria: It’s an exciting time for us. There is so much advancement in surgical techniques and navigation that surgeons are able to offer more minimally invasive procedures to ensure their patients’ form and function. Likewise, we’re starting to see that there are certain conditions that remain difficult to diagnose and treat. For example, surgery may not be quickly offered for conditions like discogenic pain, vertebrogenic pain and acute disc tears.
And that’s where regenerative medicine like orthobiologics can fit in. My work involves standardizing orthobiologic dosing protocols for various conditions and tracking my procedures and outcomes in independent, third-party registries so that we can capture prospective, anecdotal data in our private practice.
There are many of us trying to publish the best quality data and studies possible on the use of bone marrow concentration (BMAC), platelet-rich plasma (PRP) and platelet lysate. One of my interesting focus areas is the tracking of imaging changes for patients with high-intensity zones in their disc annulus. Patients may have radial or circumferential tears and, for many of them, we will repeat MRIs at either six months or 12 months to look for physical, objective changes to the disc.
Q: Are you leveraging AI to help parse and understand this data?
VB: As the data sets get larger, we will start to integrate various AI models to help sort, align and cipher through data so we can decrease the time it takes to derive meaningful conclusions. It is great how quickly such tools can be integrated into our systems.
Q: What’s been the most surprising thing you’ve found out about regenerative medicine recently?
VB: What I tell patients when they ask me about regenerative medicine, orthobiologics, PRP, stem cell therapy, etc. is that there’s no such magic injection that miraculously or instantaneously makes their problem go away. We then talk about the four pillars of regenerative medicine success: pre-procedure nutrition optimization, prehabilitation, post-procedure therapy, and the actual procedure.
Q: Are there any underrated uses for PRP that you want to see grow in spine care?
VB: In my collaboration with DISC Sports & Spine Center, I have the opportunity to join my surgical partners in their cases. If they cannot get a second-level disc replacement authorized, or they may not need to operate on certain levels, I have been able to utilize PRP during their cases on either adjacent disc segments to reduce, prevent or prolong adjacent segment breakdown.
Q: Can you dive in more when it comes to communicating with surgeons in the middle of surgery like this?
VB: I think this is where NASS and minimally invasive societies are all going with a focus on collaboration and interdisciplinary care. I already get to practice with more than 40 surgeons in my current model and the lesson learned is that communication is based on respect and trust. I am helping surgeons provide the best outcomes possible for their patients.
Q: How do you see orthobiologics continuing to evolve in spine surgery in the next five years?
VB: I’m cautiously optimistic because regenerative medicine remains unregulated. We don’t have a society or an institution that has published precise dosing protocols for specific conditions. With this freedom to operate, gathering quality data can be difficult. Interpreting results based on bad data can misconstrue outcomes and opinions of both doctors and patients. I hope we can have large multi-site, multi-center collaboration with large data to answer these technical nuances. I am confident that in five years we will get there. Our patients deserve it.
