A Case Study: UC-MSC Support for Chronic Nerve Injury and Right Hip Bursitis After Lumbar Spine Surgery

Case Overview

This case involves a patient with a history of several lumbar spine surgeries, followed by chronic nerve injury, postoperative scar tissue, neuropathic pain, and weakness affecting the right hip and leg.

According to the patient, the first XLIF procedure caused significant nerve injury near the neural foramen. He later underwent emergency revision surgery, followed by a third operation involving posterior instrumentation, pedicle screws, and foraminotomy to improve the space around the affected nerve.

The third surgery reportedly provided substantial pain relief and helped the patient regain the ability to walk. However, chronic nerve pain, altered sensation, and concerns relating to postoperative scar tissue remained.

The patient also developed right greater trochanteric bursitis, possibly related to repeated falls and altered movement during recovery.

Symptom Background

The patient reported ongoing symptoms including:

Burning or radiating nerve pain

Peripheral neuropathy and neuralgia

Pain triggered by exercise

Increased symptoms with weather changes

Discomfort after prolonged sitting or standing

Right-sided hip pain associated with greater trochanteric bursitis

His goal was to explore whether regenerative support could help reduce inflammation, support the tissues around the injured nerve, and improve discomfort around the right hip.

Medical and Surgical Background

The patient underwent three lumbar spine procedures.

The first operation was an XLIF procedure, which the patient reported was followed by significant nerve injury and severe weakness of the right hip and leg.

A second emergency revision was performed, but the patient reported that the narrowing around the right neural foramen was not fully resolved.

During the third surgery, posterior instrumentation and pedicle screws were placed, together with a foraminotomy to improve the passage around the affected nerve. The patient reported meaningful pain relief and improved mobility after this procedure, although neuropathic symptoms remained.

Imaging

The submitted images appear to be postoperative lumbar flexion and extension X-rays showing interbody fusion and posterior spinal instrumentation.

These images may be used as a general structural reference. However, formal radiological review would still be required to assess alignment, movement, fusion status, hardware integrity, residual nerve compression, or postoperative scar tissue.

Figure 1: Lumbar flexion and extension radiographs demonstrating postoperative interbody fusion and posterior spinal instrumentation.

The Patient’s Condition and the Role of UC-MSCs

This case involved two main concerns:

Chronic neuropathic symptoms following nerve injury and lumbar spine surgery

Right greater trochanteric bursitis

UC-MSC therapy cannot remove mature scar tissue, directly decompress a nerve, reposition spinal implants, or guarantee recovery from chronic nerve damage.

Its potential role is supportive and may include:

Helping regulate inflammatory activity

Supporting communication between cells

Supporting the tissues surrounding the affected areas

Complementing rehabilitation and physiotherapy

Supporting comfort and mobility

Treatment

On 20 January 2025, the patient received 60 million UC-MSCs at WIH International Hospital:

40 million UC-MSCs administered by transforaminal epidural injection at L4–L5 across two points

20 million UC-MSCs injected into the right greater trochanteric bursa

The following day, he received:

Vega Signature Vitamins Drip

NAD+ 100 mg by intravenous infusion

The treatment was designed to support the biological environment around the affected nerve region and the inflamed soft tissues of the right hip. It was not intended to eliminate scar tissue, fully repair the damaged nerve, or alter the spinal implants.

Doctor’s Perspective

From a clinical perspective, this was not simply persistent back pain after spinal fusion. The patient’s symptoms appeared to involve a combination of previous nerve compression, possible direct nerve injury, postoperative fibrosis, chronic neuropathic pain, and altered movement during a prolonged recovery.

The third surgery appears to have addressed the structural component by improving the space around the nerve and adding spinal stability. However, successful decompression does not always result in complete neurological recovery.

A significantly injured nerve may continue to produce pain, numbness, weakness, or abnormal sensation even after the mechanical compression has been corrected.

The right greater trochanteric bursitis should also be considered separately, as altered gait, repeated falls, and compensatory loading may contribute to pain around the hip.

In this case, UC-MSC therapy should be viewed as supportive care rather than a method of reversing the previous surgical injury. The goal was to support the biological environment, regulate inflammation, and complement neurological and physical rehabilitation.

Conclusion

This case involves chronic right-sided neuropathic pain following complicated lumbar spine surgery, together with right greater trochanteric bursitis.

The patient regained the ability to walk after a successful third surgery but continued to experience neuropathic pain and abnormal sensation.

He received 60 million UC-MSCs through targeted treatment at L4–L5 and the right greater trochanteric bursa, followed by supportive intravenous therapy.

The treatment should be presented as part of a broader supportive care plan, not as a guarantee of nerve regeneration, scar-tissue removal, or reversal of previous surgical complications. Long-term follow-up should assess pain, mobility, muscle strength, neurological symptoms, hip discomfort, and overall quality of life.

A Case Study UC-MSC Support for Chronic Nerve Injury and Right Hip Bursitis After Lumbar Spine Surgery