Favorable Clinical and Magnetic Resonance Imaging (MRI) Outcomes Following a Single Epidural Injection of Expanded Stem Cell Therapy in a Patient with a Treatment-Resistant Lumbar Disc Bulge and Nerve Compression: A Case Report

Lumbar disc prolapse remains one of the most frequent causes of chronic low back pain and sciatica, often leading to long-term disability and reduced quality of life. Conventional treatments such as analgesia, physiotherapy, steroid injections, and surgery provide temporary symptom relief but do not reverse the degenerative disc process and are often associated with recurrence or limited functional recovery. Regenerative medicine, particularly the use of Adipose-Derived Mesenchymal Stem Cells (ADSCs), has emerged as a novel therapeutic strategy with both structural and neuroprotective potential. This article reviews the current evidence and presents a case of a 31-year-old male with chronic, treatment-resistant L5/S1 discogenic pain who underwent autologous ADSC therapy. Stem cells were harvested from abdominal fat, culture-expanded over six weeks, and combined with autologous Platelet-Rich Plasma (PRP). A total of 100 million ADSCs were injected in into the following sites, epidural space, paraspinal deep tissues, facet joint, and interspinous bursae under ultrasound guidance. Six months after treatment, the patient reported significant pain resolution, and Magnetic Resonance Imaging (MRI) confirmed reduced disc bulge without nerve root compression. ADSCs exert anti-inflammatory, trophic, and extracellular matrix-reparative effects that target both the degenerative disc and radicular inflammation seen in sciatica. While current literature shows promising clinical outcomes and a favourable safety profile, further large-scale randomized studies are necessary to validate long-term efficacy, define optimal dosing protocols, and address regulatory and economic challenges. This case adds to the growing body of evidence supporting ADSC therapy as a viable regenerative option for discogenic back pain unresponsive to standard care. Keywords: Adipose-Derived Stem Cells; Mesenchymal Stem Cells; Lumbar Disc Prolapse; Sciatica; Regenerative Medicine; Platelet-Rich Plasma; Low Back Pain; Discogenic Pain Therapy