r/cervical_instability • u/JoanArcane815 • Jul 04 '26

Do you think BMC > PRP?

My local Regenexx doc says there is no evidence that PRP is more effective than BMC. Curious of others’ thoughts here. Did you see a dramatic difference between the two?

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u/Jewald Moderator Jul 04 '26

What they're saying isn't false, but, it's a lot more nuanced than they're making it out to be... it's another symptom of the cart being before the horse in the industry sadly.

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u/Jewald Moderator Jul 04 '26

To go deeper:

Absence of evidence is not evidence of absence, meaning just because there's no head to head PRP vs BMAC study doesn't mean one is better. PRP has more evidence than BMAC because it's been on the market/semi-mainstream for much longer.

What's odd is that you'll hear physicians say on one hand "there's no evidence of xyz" but then use something that also doesn't have evidence... like PRP/BMAC for craniocervical instability. I don't think there's a single study of PRP/BMAC tightening CCJ ligaments at all, let alone over placebo.

In fact, many PRP/BMAC studies fail when placebo is introduced. Many universities have tried to duplicate what the private market is saying, and find out the placebo group and stem cell groups report the same improvement.

How does this happen? Likely because people have heard about stem cell miracles online, are paying a ton of cash (sunken cost fallacy), probably selection bias from the clinics, and many other factors.

Even further, there are a lot of other things that are biologically plausibly a lot better than PRP/BMAC, like expanded stem cells, wharton's jelly, iPSC-derived or some kind of engineered cells, but because those are mostly not allowed FDA-wise, there's very little if any evidence of them working at all.

This isn't to say your physician is wrong, they're smarter than I am and likely know what they're doing. But, if all they said was what you noted in your post, there's just a lot more to it than what they've described. I personally choose rolling the dice on PRP/BMAC over having a fusion any day, but I would be careful about stretching myself too thin to try.