骨髓濃縮液（BMAC）是一種再生療法，醫學界對它的醫學研究和臨床應用已超過十年。它在治療慢性肌肉骨骼和脊椎痛等方面，有令人鼓舞的效果。BMAC 是從患者自己的骨髓中獲得的再生幹細胞濃縮液。它由多種生長因子、幹細胞和抗炎劑組成，可以加速癒合過程，減少痛楚和炎症。

間質幹細胞（MSC）是 BMAC 的關鍵成份。這特別的細胞相信能夠自我複製並取代損壞的組織，幫助身體修復。它們還可以分泌生長激素和其他細胞因子，增強身體的自然癒合能力，促進組織生長。此外，它可調節身體的發炎反應，以幫助防止身體在修復過情中出現自我破壞。

醫生通常會在盆骨位置採集骨髓來製作 BMAC。為了減少不適，這過程會在鎮靜或輕度麻醉下進行。然後醫生會將骨髓放進特製無菌容器，再進行離心處理，以分離出各種成份。分離出的BMAC 會被注射到需要治療的地方。由於BMAC是用作直接修復 損壞組織，它必須被精準地注射到需要修復的組織，為確保精準度，過程中醫生通常會用X光或超聲等醫學影像技術導引。

BMAC 注射可以治療各種退化,受傷或勞損引起的痛症，包括骨關節炎，肌腱和韌帶損傷，肌肉損傷，和椎間盤或機械性背部或頸部疼痛。很多都研究顯示 BMAC 在治療該類痛有效。

例如，一項隨機對照試驗比較了使用 BMAC，PRP 和透明質酸（HA）注射在治療膝關節炎中的效果。結果發現，與 PRP 和 HA 相比，BMAC 在治療膝關節炎的臨床改善方面比較優越，效果可持續長達 12 個月。

又例如，在關於脊椎疼痛的一個病例系列報告中顯示了用 BMAC 進行腰椎間盤注射可以安全有效地減輕疼痛和服用止痛藥，改善活動能力以及改善椎間盤的厚度和椎管的闊度。

雖然多項臨床試驗都顯示了 BMAC 的正面效果，但是也有些報告指出其效果並不明確。目前需要更大規模，更高質量的研究來解答這些疑問。除此之外，還需要進一步的研究來確定 BMAC 的最佳提煉方法。

BMAC 是治療慢性肌肉骨骼和脊椎痛症的一個新的選擇。它利用身體自身的修復機制來促進組織再生，減少痛楚和發炎。然而，我們仍需要更多的研究來全面了解 BMAC 的有效性，並建立最佳的治療方案。

Bone Marrow Aspirate Concentrate (BMAC) is a form of regenerative medicine that has been extensively studied and utilized in clinical settings for over a decade. It has demonstrated promising results in treating various conditions, including chronic musculoskeletal and spine pain.

BMAC is a concentrate of regenerative stem cells obtained from a patient's own bone marrow. It consists of a collection of growth factors, stem cells, and anti-inflammatory agents that can expedite the healing process, reducing pain and inflammation.

Mesenchymal stem cells (MSCs) are a critical component of BMAC. These specialized cells are capable of replicating themselves into damaged tissue to support the body's repair process. They can also secrete growth hormones and other cytokines, enhancing the body’s natural healing abilities and promoting tissue growth. Additionally, they play a role in regulating the inflammatory response, which can be detrimental to the repair process.

To prepare BMAC, a doctor harvests bone marrow, typically from the pelvic bone, under sedation or light anesthesia to minimize discomfort. The bone marrow is then centrifuged to separate its different components. The concentrate is collected in a sterile syringe and injected into the targeted area. Accurate delivery of BMAC to the damaged tissue is crucial, often guided by medical imaging techniques such as X-ray or ultrasound.

BMAC injections can treat various conditions, including osteoarthritis, tendon and ligament injuries, muscle injuries, and discogenic or mechanical back or neck pain. Numerous studies have documented the effectiveness of BMAC in treating musculoskeletal injuries and conditions.

One randomized controlled trial compared the clinical outcomes of knee injections using BMAC, PRP, and Hyaluronic acid (HA) in treating knee osteoarthritis. The study found that BMAC might be superior in terms of clinical improvements in treating knee osteoarthritis compared to PRP and HA up to 12 months.

In the context of spine pain, a case series reported that lumbar disc injections with BMAC safely and effectively reduced pain and opioid intake, improved mobility, and induced anatomical improvements in the lumbar intervertebral discs and spinal canal.

While various clinical studies show promising results, others have reported equivocal or even negative outcomes. Currently, larger-scale, high-quality studies are needed to substantiate these claims. Additionally, further research is required to determine the optimal clinical protocol for preparing high-quality BMAC.

BMAC is a promising treatment option for various chronic musculoskeletal and spine pains. It leverages the body's own healing mechanisms to promote tissue regeneration and reduce pain and inflammation. However, more research is needed to fully understand BMAC's effectiveness and establish optimal treatment protocols.

資料由疼痛醫學專科醫生

李旭明醫生提供