Alpine Spine & Orthopedics

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Innovative advancements in interventional orthopedics, complex spine, brain, nerve, pain, & sports medicine with a focus on novel regenerative minimally-invasive 3D image-guided interventions and tissue engineering techniques. Interventional Orthopedics, Nerve, Pain, & Complex Spine Disorders: Focusing on Novel Regenerative Approaches using Minimally-Invasive 3D Image-Guided Interventions.

A D1 athlete from the Northeast came to us with chest pain imitating costochondritis (and many other orthopedic injuries...
04/06/2026

A D1 athlete from the Northeast came to us with chest pain imitating costochondritis (and many other orthopedic injuries), but after detailed exam and imaging, the chest pain was found to be rare erosive arthritis of the cartilaginous manubriosternal joint causing severe chest pain to any pressure (normal ECG & ECHO). Also note the severe loss of bone density in the manubrium. This type of arthritis is frequently associated with autoimmune conditions, spondyloarthropathies, and inflammatory diseases, so an extensive set of labs was ordered, and even though she was seronegative for the classic RF, she had extremely high 14-3-3η positivity (rheumatoid arthritis marker) and extremely high Bartonella antibodies (lyme disease). The cartilaginous manubriosternal joint was patched with autologous bone marrow stem cell grafting with PRF scaffolding matrix, and she is now considering further disease-modifying peptides, proteins, and biologic agents (DMARDs), as well as basic high-dose Vitamin D3+K2 strategies. Careful diagnosis and attention to detail is essential as many rheumatic diseases also imitate, overlap, and involve orthopedic injuries.

We use 3D image-guidance to perfectly patch critical targets with a sticky protein scaffolding matrix to adhere the stem cells onto the cartilage (like re-paving a pothole in the road with asphalt) and place stem cell grafts into avascular necrosis, stress fractures, and subchondral intraosseous cysts (like patching a foundation with mortar). The high-resolution intra-operative 3D imaging enables perfect filling of the defects with the stem cell matrix graft, which adheres the stem cells directly to the injuries and enables them to integrate and thrive while rebuilding these structures. We can also place a variety of optional peptide signaling molecules to further promote repair processes and regulate autoimmunity. No other place on the planet is using such cutting-edge technologies of tissue-engineered stem cell patches with 3D image-guidance.

Copyright © 2026
Richard J. McMurtrey MD, MSc
Alpine Spine & Orthopedics Institute
All Rights Reserved





Fascinating craniocervical case of an Odontoid Fracture (Type I) due to a wrestling injury resulting in severe craniocer...
03/29/2026

Fascinating craniocervical case of an Odontoid Fracture (Type I) due to a wrestling injury resulting in severe craniocervical instability and alar ligament dysfunction. We were able to stabilize the alar ligaments and patch directly into the fracture using 3D image-guidance. The images show exact placement of the needle tip into the fracture margins, and this level of visualization and  accuracy could never be achieved with other forms of imaging like X-ray/Fluoroscopy, and we also found it to be a complex fracture with both vertical and horizontal components. Furthermore, we use a sticky fibrin protein scaffolding matrix to adhere the stem cells on the ligaments, fill the fracture with the stem cell matrix graft, and patch the damaged cartilage in the atlanto-dental interval, which is like patching with mortar while the cells act as the construction workers who remodel and rebuild over time. The scaffolding matrix adheres the cells directly to the injuries and enables them to integrate and thrive while rebuilding these structures. We can also place a variety of optional peptide signaling molecules to further promote tissue repair. No other place on the planet is using such cutting-edge technologies of tissue-engineered stem cell patches with 3D image-guidance. 

Copyright © 2026
Richard J. McMurtrey MD, MSc 
Alpine Spine & Orthopedics Institute 
All Rights Reserved 



 

Incredible case of a woman with 6 months of hip pain found to have severe erosive arthritis with "pothole" formation int...
03/29/2026

Incredible case of a woman with 6 months of hip pain found to have severe erosive arthritis with "pothole" formation into the weight-bearing cartilage, formation of a large subchondral intraosseous cyst into the acetabular ilium, and a non-displaced stress fracture of the femoral neck. She was planning to travel anywhere in the world for treatment, and she pushed through the pain seeking solutions from several surgeons before she found us, but was shocked to find we were just a few miles away! 

Because cartilage has no nerves in it, you often do not realize how quickly it is eroding. Due to a combination of low bone density and arthritis, she had rapidly formed an extremely large worm-like subchondral cyst that extended up into the weight-bearing portion of the pelvic bone as well as a stress fracture. Note how the cyst actually was starting to erode up into the pelvic inlet as well.

Dr. McMurtrey used 3D image-guidance to perfectly patch all these targets with a sticky fibrin protein scaffolding matrix to adhere the stem cells onto the cartilage (like re-paving a pothole in the road with asphalt) and into the stress fracture and subchondral intraosseous cyst (like patching a foundation with mortar). The high-resolution intra-operative 3D imaging enables perfect filling of the defects with the stem cell matrix graft, which adheres the stem cells directly to the injuries and enables them to integrate and thrive while rebuilding these structures. We can also place a variety of optional peptide signaling molecules to further promote repair, and we discussed several bone density treatments. She also had severe destabilization of the SI joints which were also patched. No other place on the planet is using such cutting-edge technologies of tissue-engineered stem cell patches with 3D image-guidance. 

Copyright © 2026
Richard J. McMurtrey MD, MSc 
Alpine Spine & Orthopedics Institute 
All Rights Reserved 





We are leading the future of minimally-invasive complex 3D-guided spinal interventions using stem cell patches with scaf...
03/19/2026

We are leading the future of minimally-invasive complex 3D-guided spinal interventions using stem cell patches with scaffolding matrix, hydrogels, and signaling factors combined into custom 3D tissue engineering constructs placed exactly at injured tissue defects for optimal integration and repair. Our ultra-high-resolution 3D imaging enables

Incredible to see another successful athlete fully return to sports with no pain and good repair after our stem cell mat...
02/22/2026

Incredible to see another successful athlete fully return to sports with no pain and good repair after our stem cell matrix patching procedures on her pars fractures! This was a uniquely interesting and complex case due to multiple prior failed back surgeries with loosening pars screws and additional fractures below the failed hardware. A local ABC News channel did this story on her spectacular return and recovery despite being told more surgery was her only option. This would not have been possible without our precision 3D image-guidance to patch around the screws and in the fractures with novel stem cell scaffolding matrix advancements, and we are grateful for the privilege to help her healing and recovery to return to the sports she loves! 🙏
She and her parents discuss more details of her journey through her injuries and recovery in the news article here: https://www.inforum.com/sports/prep/horace-senior-back-on-the-court-for-one-last-run





Interesting case of a 41yr senior software engineer who came to us for focal right-sided back pain, but his MRI only men...
02/21/2026

Interesting case of a 41yr senior software engineer who came to us for focal right-sided back pain, but his MRI only mentioned disc bulges that didn't match his pain. We found stress reactions in the pedicle and confirmed complete unilateral pars fracture on the right, as well as a variant of Bertolotti's with LSTV (blue arrows), and significant right L3-4 facet arthritis which we found was due to an L4 SAP fracture (purple arrows). The patient was shocked how these complex issues could be entirely missed and misunderstood at the big "academic" hospital systems yet so quickly elucidated at our clinic. Our novel stem cell scaffolding matrix patching procedure on the pars fracture and facet has now healed incredibly well with clear connective tissue bridging and medullary callus ossification in the pars (green arrow), which required using a trocar to puncture small holes through the fracture margins, and even though the new bone is not as dense, it will continue to solidify over time. We also patched the facet joint, and told him the fragment would likely not re-unionize because it was small and already had some reabsorption, but we could help the more important aspect of restoring capsular integrity and cartilage of the facet joint to be able to properly move and bear weight. As predicted, the small facet fragment has not fused, but his pain and activity have improved dramatically ("night to day difference") and he was extremely grateful he found us. Nevertheless, there is not any surgery on earth that can fix everything in every case or that fully resolves everyone's pain (data show that nearly half of spinal hardware fusions eventually results in worse back pain, failed back surgery syndrome, inevitable adjacent segment disease, etc), so naturally not all of these regenerative approaches with stem cell scaffolding matrix will result in complete repair. But we give every effort we can to repair these complex injuries with our 3D-guided minimally-invasive tissue engineering procedures, which have enabled numerous patients to heal, repair, return to function, and avoid surgical hardware from a wide variety of injuries.

ASOI © 2026


Thanks Ben, grateful to be a part of your recovery! 🙏
02/20/2026

Thanks Ben, grateful to be a part of your recovery! 🙏

02/17/2026

Another case of clavicle fracture from a traumatic fall which also resulted in craniocervical ligament injuries that were missed, similar to the prior case we posted. This patient took a hard hit in D1 Lacrosse that resulted in a clavicle fracture that was left to heal on its own. Persistent neck pain, headaches, chest pain, and shoulder pain led her to seek further treatment, but doctors repeatedly dismissed her telling her that nothing else was wrong and her pain was all in her head. We recommended further imaging including an upper cervical MRI which revealed significant ligament and joint injuries that correlated with her symptoms. We also discovered that not only had she fractured her clavicle but also had a significant manubriosternal joint subluxation and large AC joint shoulder separation. We also found that she had congenital posterior arch dysplasia (type A unfused hemiarches resulting in a posterior median cleft, making her more susceptible to injury). We perfectly targeted all these injuries with 3D image-guided stem cell patching with sticky protein/peptide matrix scaffolding, which involved our unique "double quad" approach (both anteriorly and posteriorly) to target the damaged ligaments and joints.

Copyright © 2026
Richard J. McMurtrey MD, MSc
Alpine Spine & Orthopedics Institute
All Rights Reserved





Fascinating case this week showing the long-term effects of upper cervical ligament injury. A healthy elderly woman pres...
02/14/2026

Fascinating case this week showing the long-term effects of upper cervical ligament injury. A healthy elderly woman presented with severe neck pain, and for as long as she can remember it hurt most on the left upper side near the base of the skull, with pain-limited rotation of the head. Her adult daughter said that growing up she always had hot and cold packs on her left upper neck. Her MRI showed multilevel disc disease worst at C5-6-7, and traditional neurosurgeons would have done a multi-level fusion surgery here. However, she insisted her worst pain was directly at the base of the skull on the left side, but the radiology reports made no mention of any problem there. Our advanced 3D imaging confirmed severe C1-2 Atlanto-Axial arthritis only on the left side (notice how the right C1-2 has almost no arthritis at all!), which is a consequence of right alar ligament injury that allowed the unstable left C1-2 joint to shift and grind down over time, similar to how a pothole develops the road, ultimately causing stage IV arthritis with subchondral cyst formation. She had several falls in her life but could not remember any specific serious trauma (she felt this likely occurred in her youth and she just toughed it out her whole life). The chances of successful treatment are always much higher if caught and treated early, and sometimes a high pain tolerance causes longer unnecessary suffering with catastrophic long-term consequences. Nevertheless she did great with the stem cell patching procedures, which fill in the cartilage defects with a regenerative hydrogel patch consisting of stem cells with scaffolding matrix (like repaving a pothole in the road) and she is already feeling more cushioning, stability, and more relaxed neck muscles, and she was grateful we finally figured out the source of her problem after all these years and didn't jump into an unnecessary fusion that wouldn't have even helped her pain! 

Copyright © 2026
Richard J. McMurtrey MD, MSc
Alpine Spine & Orthopedics Institute
All Rights Reserved





Over a decade ago Dr. McMurtrey was bolting bones of the spine and skull back together, but was frustrated that we still...
02/12/2026

Over a decade ago Dr. McMurtrey was bolting bones of the spine and skull back together, but was frustrated that we still do nothing to repair brain and spinal cord tissue injuries. He had the idea of rebuilding 3D neural tissue using patterned nanofibers in biocompatible hydrogels that 1) replicated neural network pathways, 2) were functionalized with axonal guidance molecules, 3) embedded nanofibers within functionalized hydrogel scaffolding to enable neural proliferation and 3D spatial neurite guidance, 4) used certain types of peptides and proteins to control neural tissue environment to prevent astrogliosis and scar proliferation, and 5) be biocompatible at the neural interface for cellular integration with matching elastic modulus. He wrote up a research proposal but the NIH rejected these ideas as "unlikely to work," so he instead applied to Oxford University to see if he could pursue this novel research there, and they gave him a lab but said the rest would have to be self-funded since he was not an EU or UK citizen. While there he not only successfully achieved his ideas but also was able to reprogram patient's own cells to create neural organoids and stem cells to rebuild in vitro neural tissue with nanofibers, hydrogels, and peptide signaling factors.

Today over a decade later, similar research has just been published on how to protect and repair injured spinal cord organoids using combinations of peptides, hydrogels, and nanofibers to fill the lesion gap and guide beneficial repair. There are still some weaknesses to their approach in a living human, but the concept remains the same as what Dr. McMurtrey envisioned and published over a decade ago for how to best approach these injuries. Dr. McMurtrey was the only resident at his program who could work two back-to-back call shifts (65 hours without sleep) then work in the lab on his "time off." Beautiful to see all this work starting to come full circle-- see if you can tell which images were just published today vs Dr. McMurtrey's from 2016!

Takata et al. "Injury and therapy in a human spinal cord organoid" Nature Biomedical Engineering 2026



Yet again we have seen numerous athletes where spine fractures nearly ended their careers, yet who then had enough heali...
12/31/2025

Yet again we have seen numerous athletes where spine fractures nearly ended their careers, yet who then had enough healing and repair from our minimally-invasive regenerative procedures to fully return to sports. It is never a guarantee of course, but far better to try these less invasive approaches before jumping to much higher-risk spinal hardware surgeries with irreversible long-term consequences and high complication rates. These outcomes are worth all the late nights and long years of research to push the future of tissue engineering into more successful reparative approaches. This patient wrote the following review (case & photo posted with permission) which means the world to us:

"I am a 19 year old female high jumper who jumps in the ACC at the University of North Carolina at Chapel Hill. In the Fall of 2024, I found out I had a bilateral pars fracture of my L5 vertebrae. I also had a few annular tears to the surrounding disks. Upon further examination, my case became more complex involving the early destabilization of my SI joints and fluid in my facets. Our main concern was healing my pars fracture, which would be very hard to do with just rest and no intervention considering that my bones were calcified apart instead of healed together. Surgery was an option, but would limit my mobility, so we researched alternative solutions that would aid in healing. We came across Dr. McMurtrey at Alpine Spine & Orthopedics and his stem cell procedures and immediately started researching. The results for young adult athletes, like me, were spectacular…. I have gradually worked up to full activity without any back pain whatsoever. I modify my lifts so I am not back squatting, dead lifting, or power cleaning, but besides that I have full mobility and strength and no pain. I am so grateful to say that I just competed in my first collegiate track meet a few weeks ago jumping an indoor season personal record and with no pain. Without Dr. McMurtrey my pars would have not had what it needed to grow back together and to provide stability. I am forever thankful for Dr. McMurtrey and for the good Lord for getting me back to my sport!"


3D-Guided Upper Cervical Spine Regenerative 3D Stem Cell Patching: AtlantoAxial AtlantoOccipital CranioCervical C0-1 & C...
12/29/2025

3D-Guided Upper Cervical Spine Regenerative 3D Stem Cell Patching: AtlantoAxial AtlantoOccipital CranioCervical C0-1 & C1-2 Minimally-Invasive Interventions.

Trans-oral and trans-nasal approaches to the cervical spine have been done for well over 100 years, including to the pituitary by Harvey Cushing in the 1900s then craniovertebral pathologies as early as 1917 for atlantoaxial subluxation as well as resection of tumors, tuberculosis, and even a bullet! Then in the 1980s Dr. Arnold H. Menezes significantly advanced these approaches and techniques to dramatically improve both safety and efficacy to make this approach the mainstay for these unique pathologies.

Dr Richard J. McMurtrey was able to operate with several of these legends and innovators in neurosurgery, including Dr. Arnold H. Menezes himself on atlantoaxial instabilities and craniocervical subluxations, as well as Dr. John A. Jane and Dr. Edward H. Oldfield on numerous trans-oral and trans-nasal cases as well as complex pediatric brain and spine pathologies, in addition to many traumas at Denver General county hospital, and he uses this experience along with ultra-high-resolution 3D image-guidance to target these injuries and pathologies with the most exact minimally-invasive techniques.

Shown are just a few of the cases Dr. McMurtrey has performed to the anterior upper cervical spine. These injuries are also comorbid with numerous other pathologies. Our prior posts showed some of the complex anatomy with upper cervical procedures around brainstem, spinal cord, and critical arteries, and Dr McMurtrey uses his expertise in tissue engineering and stem cell research at the University of Oxford to create bespoke 3D stem cell patches with scaffolding matrix to help adhere and integrate the cells directly into tissue defects and injuries like C0-1, C1-2, & alar and transverse ligaments specific to each patient’s injuries. More detailed videos coming soon.

www.AlpineSpineOrthopedics.com

Copyright © 2025 ASOI
Richard J McMurtrey MD MSc
All Rights Reserved





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920 E 800 N Suite 202
Orem, UT
84097

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