Gregory Lutz

Gregory Lutz
Hospital for Special Surgery · Department of Physiatry

MD

About

79
Publications
13,320
Reads
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3,295
Citations
Introduction
Additional affiliations
January 1993 - present
Hospital for Special Surgery
Position
  • Physiatrist-in-Chief Emeritus
January 1993 - present
Weill Cornell Medicine
Position
  • Associate Professor of Clinical Rehabilitation Medicine

Publications

Publications (79)
Article
Full-text available
Purpose This study aimed to assess clinical outcomes following intradiscal injections of higher-concentration (> 10 ×) platelet-rich plasma (PRP) in patients with chronic lumbar discogenic pain and to compare outcomes with a historical cohort. Methods This retrospective study included 37 patients who received intradiscal injections of higher-conce...
Article
Full-text available
Background: Intervertebral disc disease (IDD) is responsible for a large portion of back pain with historically suboptimal treatments for long-term improvement. IDD pathogenesis is thought to arise at a cellular and biochemical level, making biologically based injections an area of clinical interest. Although human studies have shown promise, emer...
Article
Background: Interventional spine procedures, such as discography, epidural steroid injections (ESIs), facet joint procedures, and intradiscal therapies, are commonly used to treat pain and improve function in patients with spine conditions. Although infections are known to occur following these procedures, there is a lack of comprehensive studies...
Article
Introduction Point‐of‐care analyses of platelet‐rich plasma (PRP) are not routine in the orthopedic regenerative medicine field. Therefore, many physicians rely on the manufacturer's reported content for commercial preparation kits. This contributes to a knowledge gap between injectate content and patient outcome. Objective To assess whether the E...
Article
Full-text available
Introduction Knee osteoarthritis (OA) is characterized by pain and functional deficits. Common conservative strategies include medications, physical therapy, and intra‐articular injections. Recently, treatment using autologous cell injections has increased. Objective To characterize the cellular content of BMA and to evaluate the effect of intra‐a...
Article
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Aim: The most common risk associated with intradiscal injection of platelet-rich plasma (PRP) is discitis with Cutibacterium acnes. It is hypothesized that antimicrobial activity of PRP can be enhanced through inclusion of leukocytes or antibiotics in the injectate. Materials & methods: Multiple PRP preparations of varying platelet and leukocyte co...
Article
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Aim: This study assessed pain and function at 5–9 years postinjection in a subset of patients who received intradiscal platelet-rich plasma (PRP) injections for moderate-to-severe lumbar discogenic pain. Patients & methods: All patients received injections of intradiscal PRP in a previous randomized controlled trial. Data on pain, function, satisfa...
Article
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A 40-year-old woman with a history of chronic low back pain underwent a fluoroscopically guided intradiscal platelet-rich plasma injection (PRP) at the L5–S1 level. She subsequently developed progressive low back pain, night sweats and decreased ability to ambulate. Laboratory work-up revealed elevated acute phase reactants and imaging revealed L5–...
Article
Purpose To determine if axial low back pain (LBP) associated with central disc protrusions can be improved by caudal epidural steroid injections (ESIs). Methods Adults with chronic (> 3 months) moderate-to-severe axial LBP with L4–5 and/or L5-S1 central disc protrusions were enrolled in this prospective study. Participants underwent caudal ESIs un...
Article
Background: Although lumbar zygapophyseal joint synovial cysts are fairly well recognized, they are an uncommon cause of lumbosacral radicular pain. Non-operative treatments include percutaneous aspiration of the cysts under computed tomography or fluoroscopic guidance with a subsequent corticosteroid injection. However, there are mixed results in...
Article
A literature review of clinical and translational studies was performed to provide an overview of current concepts on regenerative treatments for spinal conditions, including platelet rich plasma and stem cell treatments to treat low back pain.
Article
Full-text available
Background Chronic low back pain due to disc degeneration represents a major social and economic burden worldwide. The current standard of care is limited to symptomatic relief and no current approved therapy promotes disc regeneration. Bone marrow-derived mesenchymal stem cells (MSCs) are easily accessible and well characterized. These MSCs are mu...
Article
Purpose: The aim of this article is to provide an overview of clinical and translational research on intradiscal platelet-rich plasma (PRP) as a minimally invasive treatment for discogenic low back pain. Methods: A literature review of in vitro, in vivo, and clinical studies was performed. Results: There is strong in vitro evidence that suppor...
Article
Full-text available
To determine if single injections of autologous PRP into symptomatic degenerative intervertebral discs (IVDs) will improve participant-reported pain and function. Prospective, double-blind, randomized controlled study. Outpatient Physiatric spine practice. Adults with chronic (≥ 6 months) moderate to severe lumbar discogenic pain, unresponsive to c...
Article
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We report a case of an 83-year-old gentleman presenting with acute low back pain and radicular left lower extremity pain after golfing. A magnetic resonance imaging (MRI) of the lumbar spine revealed a low-signal-density lesion compressing the L5 nerve. A computed tomography scan was then ordered, confirming an extra-foraminal disc protrusion at th...
Article
Commentary on: Bydon A, Xu R, Parker SL, et al. Recurrent back and leg pain and cyst reformation after surgical resection of spinal synovial cysts: systemic review of reported postoperative outcomes. Spine J 2010;10:820-826 (in this issue).
Article
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Zygapophysial joint (z-joint) pain has long been suggested to be one of the sources of low back pain. Radiofrequency denervation of the medial branches of the dorsal rami to treat z-joint pain is an outpatient minimally invasive treatment option. There have been many short-term studies to determine the outcome of the procedure, but few long-term st...
Article
Lumbar zygapophyseal joint (Z-joint) synovial cysts can cause low back pain (LBP), spinal stenosis, and lower extremity radiculopathy. In the literature, there are several minimally invasive techniques described with mixed results. Typical recommended treatment is surgical resection of the cyst. Currently, there is little information available conc...
Article
Full-text available
Modification of the implant surface with the Arg-Gly-Asp tripeptide (RGD) putatively facilitates osteoblast attachment for improved implant fixation in the laboratory. We compared the histomorphometric and mechanical performance of titanium implants coated with RGD using a novel interface of self-assembled monolayers of phosphonates (RGD/SAMP) and...
Article
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To determine the effectiveness of ultrasound-guided aspiration and lavage in the treatment of patients with calcific tendinosis of the shoulder. Retrospective chart review resulted in 44 patients who were identified as having received ultrasound-guided aspiration of calcific tendinosis of the shoulder between 2000 and 2003. Of these, 36 patients we...
Article
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The mechanism of pain relief of intradiskal electrothermal annuloplasty (IDET) in the treatment of lumbar diskogenic pain is uncertain. Theories include sealing of annular fissures via collagen denaturation and contraction. Prior studies offer conflicting qualitative data on the ability of IDET to denature collagen. The objective of the present stu...
Chapter
Neck pain is a very common complaint, affecting up to 70% of the population at some point in their lives. This makes neck pain the second most common presenting musculoskeletal complaint (second only to low back pain). Any structure that receives innervation can be a likely pain generator in the neck. Potential causes of mechanical neck pain includ...
Article
The reported complication rate of provocative lumbar discography is low, ranging from 0-2.5%. We report five cases of acute lumbar disc herniation precipitated by discography, a previously unreported complication. The cases reported comprise of four men and one woman with ages ranging from 23-45 years. All developed an acute exacerbation of radicul...
Article
Although rare, sacral stress fractures may occur in pregnant women, and osteoporosis of pregnancy is a poorly understood entity. We present the case of a young, postpartum, recreational runner who developed low back pain (LBP) and radicular symptoms suggestive of L5 radiculopathy found to be secondary to sacral stress fracture. The patient had a go...
Article
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The use of epidural steroid injections as a treatment for patients with degenerative lumbar scoliotic spinal stenosis and radiculopathy has received sparse attention in the literature. Even though it has been reported that patients with scoliosis may respond differently than other patient groups to conservative therapeutic interventions for low bac...
Article
Full-text available
Degenerative lumbar spinal stenosis is a frequent cause of disability in the elderly population. Epidural steroid injections are a commonly used conservative modality in the treatment of patients with degenerative lumbar spinal stenosis. Relatively few studies have specifically addressed the efficacy of epidural steroid injections for spinal stenos...
Article
This is a case report of a cervical epidural abscess presenting with neurologic deficits after cervical epidural steroid injection. To describe the presentation, diagnosis, treatment, and outcome of a rare complication of cervical epidural steroid injection. Cervical epidural steroid injections are a commonly used modality in the treatment of cervi...
Article
Lumbar intraspinal synovial cysts are an important cause of axial and radicular spine pain. Controversy about nonsurgical versus surgical treatment persists. To evaluate the efficacy of nonsurgical management of symptomatic lumbar intraspinal synovial cysts (LISCs). Retrospective review set in outpatient physiatry office. Ten patients (8 women, 2 m...
Article
Full-text available
To characterize the histologic effects of coblation nucleoplasty on sheep intervertebral discs. In vitro histologic study. Five sheep lumbar discs treated with nucleoplasty and two control discs were evaluated. Specimens were received frozen and thawed to room temperature. A segment consisting of the intervertebral disc and vertebral body above and...
Article
Full-text available
To determine the long-term efficacy of IDET in the treatment of chronic lumbar discogenic pain. Prospective case series clinical outcome study. IDET was performed on 62 consecutive patients with chronic discogenic pain of greater than 6 months duration and consecutively enrolled in a non-randomized prospective case series outcome study. Outcome mea...
Article
Objective: To evaluate the effectiveness of fluoroscopic transforaminal epidural steroid injections as a conservative treatment for patients with degenerative lumbar scoliosis and radiculopathy. Design: Retrospective follow-up study. Setting: Academic outpatient physiatric interventional spine practice. Participants: 62 patients with radiographic e...
Article
Objectives: To evaluate failure of intradiskal electrothermal annuloplasty (IDET) in patients with repeat diskography and to report their findings. Design: Retrospective chart review. Setting: Academic physiatric outpatient private practice. Participants: Of 150 patients who underwent IDET, 8 patients who failed after 1, 2, or 3 level IDET and unde...
Article
Setting: University-based physician’s office. Patient: A 13-year-old gymnast who was in good spinal health until she was a restrained front-seat passenger in an automobile collision. Case Description: She had immediate onset of severe low back pain (LBP) that became chronic and limited her ability to participate in athletic activities. She was seen...
Article
Objective: To assess the efficacy of fluoroscopically guided caudal epidural steroid injections (ESIs) in the management of lumbar spinal stenosis. Design: Retrospective chart review and follow-up study. Setting: Academic-affiliated outpatient physiatry practice. Participants: Patients with low back and/or leg pain of at least 3 months in duration...
Article
Objective: To determine the efficacy of fluoroscopic caudal epidural steroid injections (ESIs) as a conservative treatment in patients with presumably chronic lumbar diskogenic pain. Design: Retrospective follow-up study. Setting: Physiatric interventional spine practice in a large, urban, academic institution. Participants: 97 patients from chart...
Article
Objective: To determine the long-term efficacy of intradiskal electrothermal therapy (IDET) in the treatment of chronic lumbar diskogenic pain. Design: Prospective case series clinical outcome study. Setting: Academic-affiliated private physiatry practice. Participants: 62 consecutive patients with chronic diskogenic pain of >6 months in duration a...
Article
Setting: Academic outpatient physiatric spine practice. Patient: A 32-year-old woman. Case Description: The patient was referred for evaluation of coccygeal pain. Her pain began 3 months prior during a spontaneous vacuum-assisted vaginal delivery of a healthy 8lb boy. The fetus was not in breech, however, his head was turned to the side, making pas...
Article
Objective: To characterize the histologic effects of radiofrequency nucleoplasty on sheep disks. Design: In vitro histologic study. Setting: Hospital-based soft-tissue research laboratory. Animals: 5 sheep lumbar disks treated with nucleoplasty and 2 control disks. Interventions: Specimens were received frozen and thawed to room temperature. A segm...
Article
Full-text available
Lumbar zygapophyseal joints have long been considered a source of low back pain with or without leg pain. The objective of this prospective study was to investigate the therapeutic effectiveness of lumbar zygapophyseal joint radiofrequency denervation (RFD) followed by physical therapy, for the treatment of refractory lumbar zygapophyseal joint med...
Article
Full-text available
This study sought to determine the efficacy of fluoroscopic caudal epidural steroid injections as a conservative treatment in patients with presumably chronic lumbar discogenic pain. Epidural steroid injections have been used in the treatment of lumbar radicular pain with success. However, despite their widespread use, there are few, if any, report...
Article
To determine the clinical efficacy of intradiskal electrothermal annuloplasty in treating patients with chronic constant lumbar diskogenic pain who have not responded to at least 6 months of aggressive nonoperative care. Prospective case series. Academic-affiliated private physiatry practice. Thirty-three patients with chronic constant lumbar disko...
Article
Lumbar zygapophyseal joint cysts are potential pain generators in patients with axial pain and/or lower-limb radicular pain. The traditional treatment of symptomatic cysts that do not respond to conservative measures is surgical decompression. Percutaneous needle aspiration under fluoroscopic guidance is a potential minimally invasive treatment opt...
Article
A prospective study randomized by patient choice from the private practice of a single physician affiliated with a major teaching hospital was conducted. To compare transforaminal epidural steroid injections with saline trigger-point injections used in the treatment of lumbosacral radiculopathy secondary to a herniated nucleus pulposus. Epidural st...
Article
To characterize descriptively the histologic and temperature effects of intradiskal electrothermal annuloplasty on human cadaveric lumbar disks. In vitro histologic study. Hospital-based soft-tissue research laboratory. CADAVERS: Six human cadaveric lumbar disks, from 5 cadavers aged 39 to 79 who died from nonspine-related causes. Intradiskal elect...
Article
To assess the stability of the human lumbar cadaveric spinal motion segment before and after treatment with intradiscal electrothermal therapy (IDET). An in vitro biomechanic analysis of 5 human cadaveric spinal motion segments by using nondestructive biomechanic testing in flexion/extension, lateral bending, and axial rotation with loads of 0N, 60...
Article
Axial back pain is commonly encountered by the sports medicine physician and has a variety of potential pain generators. Internal disc disruption is an important diagnosis to consider, particularly if there is a history of spinal trauma. The pathogenesis of IDD is not definitively known, although related theories exist. The process may begin with a...
Article
This report describes a case of a professional baseball pitcher who developed acute left lumbar radicular symptoms after a baseball game and was subsequently sidelined for the rest of the season. Physical examination revealed depressed reflexes in the left posterior tibialis and left medial hamstring muscles, mild weakness in the left extensor hall...
Article
A 43-year-old man developed progressive calf pain and paresthesias after a strain of the right gastrocnemius muscle. Physical examination revealed sensory loss in the distribution of the sural nerve with a positive Tinel's sign in the posterior calf in the region of his previous injury. Electrodiagnostic studies revealed prolongation of the sural d...
Article
To determine the therapeutic value and long-term effects of fluoroscopic transforaminal epidural steroid injections in patients with refractory radicular leg pain. Although numerous studies have evaluated the efficacy of traditional transsacral (caudal) or translaminar (lumbar) administration of epidural steroids, to our knowledge no studies have a...
Article
The purpose of this study was to analyze intersegmental forces at the tibiofemoral joint and muscle activity during three commonly prescribed closed kinetic chain exercises: the power squat, the front squat, and the lunge. Subjects with anterior cruciate ligament-intact knees performed repetitions of each of the three exercises using a 223-N (50-po...
Article
Samenvatting Het concept van de kinetische keten werd aanvankelijk ontworpen voor verbindingsanalyse in de mechanische technologie maar wordt sindsdien ook toegepast op de kinetica van het menselijk lichaam. Steindler opperde dat in het menselijk lichaam elke extremiteit kon worden beschouwd als een keten bestaande uit rigide, elkaar overlappende s...
Article
The purpose of this study was to analyze forces at the tibiofemoral joint during open and closed-kinetic-chain exercises. Five healthy subjects performed maximum isometric contractions at 30, 60, and 90 degrees of knee flexion during open-kinetic-chain extension, open-kinetic-chain flexion, and closed-kinetic-chain exercises. Electromyographic acti...
Article
A wide spectrum of protocols is available for rehabilitation after anterior cruciate ligament reconstruction, and little agreement exists on the specifics of strengthening exercises or the sequence of activities. In this article, we discuss the current rehabilitative techniques used at the Mayo Clinic for athletes who have undergone anterior crucia...
Article
Full-text available
baseball pitchers with a diagnosis of lum- bar zygapophyseal joint synovitis mediated low back pain and a subsequent diffi culty in pitching. These athletes underwent a trial of treatment, including oral anti-infl ammato- ry medication, physical therapy, osteopathic manipulations, and fl uoroscopically guided intra-articular zygapophyseal joint inj...

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