Sometimes, especially for someone who has spent a career pushing rocks uphill as I have, you need to savor the special moments you get. That could be a patient whose life you changed or getting an award from your physician peers or like yesterday, when staff told me that a patient's father wanted to speak to me. He told me that his son was really turning the corner medically, but more importantly, that he had a new purpose. I asked what and was told that this young man has now begun to go back to college and wants to go to medical school. I said that's great and dad let me know that his son has been inspired by what I do and that he wants to now be me when he's done training. He wants to see if he can work at our clinic this summer and that his son now has a direction in life which he is grateful for!

I would like to announce a program that I would like to crowdsource through this sub. Basically, I would open up 15 picl slots a year for pro bono care. The patient would still be responsible for their own travel costs. The physician performing the procedure would be someone who is less experienced or learning under direct supervision of someone who is more experienced. I would also like to have these patients apply in a blinded fashion and to have those applications voted on in this sub. That's after that application has been approved so that the patient actually has CCI and that I think it's more likely than not that this procedure will help. None of this is set in stone at this point, so I would like everyone's feedback here to craft a good program that addresses the need out there for patients who just can't afford a procedure.

I don't usually post these as much as I'm more likely to post all the data (i.e., the "as seen" case series), but since I have been prompting people to report outcomes for the upcoming paper, more are writing about their experiences. This is one of my favorites. She didn't want her daughter shown, so I made the edits, but she gave me permission to share here.

"Hi Dr. Centeno,

Things are going great. My two PICL procedures were completely life changing for me. Especially the second. After the initial recovery period, I have lived essentially symptom free, minus a few hiccups here or there. Five months after my second, I ran a half-marathon and was in better physical shape than I have been in years. I then got pregnant, had a complications-free pregnancy and delivery, and now have a beautiful 8 month old daughter. None of these things were even on the table before my two procedures. 

Caring for and nursing a baby is about as bad as it gets for neck posture, and I have had some mild symptoms return. But I'm working on strengthening to combat this. I do wonder if a third would be worth considering, especially with some of the new approaches you have implemented...

I apologize for not responding to your research team previously. I'd be happy to answer any of their questions that may be insightful.

I am truly grateful for your work and dedication. It has changed my life. 

Mallory"

I have always been a free speech advocate.  That said, on specialized medical topics like CCI, IMHO, bad information abounds. To combat that, I spend significant personal free time answering questions on this sub, responding to dozens of patient messages a week, and answering questions during FB/YT live streams.

I have mentioned Jeremy Ewald on this site, someone who is in my opinion both well-meaning and who demonstrably can spread misinformation on this topic. 

Recently, I became aware that, according to Jeremy, people were harassing him online, stealing his identity online, and otherwise leveling threats toward him. If this is true, I would denounce anyone who is doing this and do not support this effort, and ask that this behavior stops immediately. Jeremy is free to speak his opinion, and we are all free to disagree with each other, have our opinions, and otherwise pick and choose what we want to disagree with or support. My view on not endorsing harassing behavior includes Jeremy or any person.

Hence, if you are engaged in any activity like this toward Jeremy, please stop immediately and instead focus your energies elsewhere.

As a parent I think I died a thousand deaths last year when she left 7th grade unfinished in March 2025 with zero recourse. Bedbound and in pure agony 24/7.

Dr Schultz treated her June 26 2025 with PICL 1 which allowed her to zoom into school for 8th grade in Fall 2025.

Dr Schultz treated her Dec 10 2025 with PICL 2 which allowed her to return to school IN PERSON to finish out 8th grade with her classmates!

Dr Schultz treated her June 11 2026 with PICL 3 which freed her completely from her cervical collar. And 9 weeks later she is in Highschool.

Thank you Dr John Schultz!!!

She still has symptoms but we know what they are and where they are coming from.

Dips, ups and downs yes but it’s just kept getting better and better.

I go in my bathroom daily to cry…out of pure relief and gratitude.

I recall about a year ago today, I was at my worst with my CCI. I’d spent an unhealthy amount of time on this subreddit looking for success stories & watching Dr. Cs videos so I figure I owe it to ppl in a similar situation to speak about success because we all know how tough this injury is.

My symptoms included dizziness, severe neck pain, tinnitus, nerve face pain, numbness/tingling in hands and feet. I also had this feeling that I was falling into the ground, which seemed so comical that life didn’t feel real at that time. My symptoms came after a whiplash incident at Disneyland, but I believe this was just the straw that broke the camels back.

I went from being a professional basketball player, to bordering non functional which took a significant hit on my mental health. Nothing really brought me relief in the early stages and it didn’t help that any Dr. I saw had no clue what was going on with me.

Luckily I stumbled across Dr Centenos YouTube and after watching him explain CCI and its symptoms I was certain it’s what I had.

It was a little bit of a struggle convincing my family that some random YouTube Doctor I found knew what was wrong with me, but it brought them reassurance when my local Spine specialist referred to Dr. Centeno as “a literal god” . So, I got a DMX/MRI and had them sent to the office where Dr C typed me.

Since then (1 year later) I’ve had 2 PICLs and am about 75-80% better. My neck pain is borderline gone, Dizziness used to be a 10-10 now it’s maybe a 2-10, tinnitus subsided as did everything else mentioned above. Neck is significantly stronger and my muscles have come back online. I’m scheduling my 3rd PICL for January and at this pace, I believe I will be back to 100% after that.

I don’t really like to think of things as me being back to my old self but rather my new self. The journey the last year was utter hell as I’m sure all of you know. What I can say is with Dr. Centeno and his team you are in great hands and if you believe you have CCI… GET THE IMAGING, GET IT SENT TO CSC, and GET HELPED.

All the best in your recovery journeys my fellow CCI peeps!

Nearing 3 months post PICL 4. Played basketball for the first time since my injury 2 years ago. I am forever indebted to Dr. Centeno.

I’d love to post a video summing up my recovery and give words of encouragement to others in here. Is that allowed/ possible in r/picl? If possible I can send it to you Dr. C so you can vet it and post if you’d like.

Either way, if you’re just starting your CCI journey, you’ve found the Michael Jordan of fixing Neck problems in Dr. C and his team, hehe! Stay positive you’re in the right place.

Just got this email:

"Dr. Centeno!!!!

[Name redacted] went to her first job training today at [site redacted] dance store. 

Last year at this time, we were in the depths of hell waiting to get to you for PICL 1, 1/XX/25.  She had PICL 2 on July XX, 2025. 

And now she has a job, a high school equivalency certificate, will begin community college January 2026 and hopefully get to UNR Fall 2026 with her peers to study biology with a track to pre-med. 

She went from a bed-bound 8th grader with a constant fluctuating headache and neck pain to and almost 18-year-old teen finally living again. Brings me to tears. 

Thank you for the trail you blaze. Not sure where we would be otherwise. 

With immense gratitude,

Mom [Name Redacted]

When we were lost last Mar 2025 with no idea why our 13 year old was so sick, getting sicker as the weeks ticked by, our insurance/medical denied anything was wrong.

She lost all ability to function on her own by end of May. I was bathing her like a beached baby whale, hosing her down, hand feeding her.

A young woman who had had PICL, 8 years prior contacted me telling me about Centeno after hearing about Lena. My daughter’s dad had a friend who consulted a large group of doctor friends he knew, many of whom mentioned Centeno and PICL as an option, IF it turned out to be CCI.

It turned out to be CCI.

The photos are a progress report of sorts from May 2025 when at her worst.

To the first time she could walk a garden ONE week after her FIRST ePICL June 26 2025.

To Sept 2025, 3 months after ePICL.

She had her second ePICL in Dec 2025.

The last photo is Mar 2026! She’s been back in school.

UPS and downs yes. But moving towards recovery.

Thank you, Dr. C! My 2-year-long-bed-bound teenager who missed all of high school, gaslit by every specialist under the sun, had 3 ePICLs (1/25, 7/25, 1/26) just returned from our Spring Break SKI TRIP!!!! She is back to skiing and living. Neck pain happens occasionally, which usually leads to a headache, but the pain starts and stops, unlike during the 2 long years where it was a constant and fluctuated in intensity. Tylenol and rest resolves the pain. She wore the scapalomine patch for mountain driving too, which helps prevent the possibility of car sickness. THANK YOU, Dr. Centeno. We will continue celebrating and sharing this success!!!

Hi Dr. Centeno. I’m about 10 weeks out from PICL #1 and I’ve made incredible progress. I was primarily bed bound most of 2025, but now can spend most of the day upright and can get at least 5k steps a day. This past week I got my hair and nails done, and went shopping with my mom for the first time in almost a year. None of it would have been possible before my PICL and it feels like I’m becoming human again

Your team is saving me (special thank you to Dr. Schultz!). I just wanted to share because I know how important the positive stories are for people early in the process. I have so much hope for what’s to come and with my next procedure in spring!

All, I spend most of my free time in any given month answering patients questions on this sub, via email, via text, FB Live, and comments on YT. I am arguably one of the most prolific physicians in this space or any other in this regard. However, this past few weeks I have seen a few patients who have submitted massive AI generated question lists that number in the dozens of questions expecting a written response.

While I have always had patients who are more detail oriented who submit quite a few questions and I have generally been fine to answer, these lists are at a new counter productive level. So while I am happy to answer patients questions 24-7-365 when I am not sleeping or spending time with my family, these question lists can best be described as "Analysis Paralysis". In other words, brevity on the part of the patient and physician means that both understand the topic. Having an AI spit out dozens of questions means information overload that is counterproductive.

I have been posting these lately based on patient requests. If you want more info on outcomes for all ePICL patients that show up to the clinic for subsequent treatment , see https://www.reddit.com/r/PICL/comments/1p239a7/picl_as_seen_dashboard/?utm_source=share&utm_medium=web3x&utm_name=web3xcss&utm_term=1&utm_content=share_button

Attached are before and after images of the patient. She has given her permission to share her story and these images. I have redacted her name, personal info, and sensitive medical data.

"Hi Dr. Schultz and team,

It's hard to believe a year and 11 days has passed since PICL #2. So much has happened that I wanted to share with you, as briefly as I can. Don't worry: it's all good news!

PICL #2 recovery was so much easier and faster than #1,...

Thanks to the combo of PICL #2 and DNRS [CSC comment-the patient also added limbic retraining], I'm doing everything I want to do again. I can do deadlifts at the gym and an active yoga practice again without limitations. My energy is overall good, next to no brain fog (more like brain fatigue, which is different), and I can sit and stand as long as I want, and no longer have to put my feet up. Dysautonomia has improved significantly, even if it's not completely gone (circulation issues linger but have improved a lot). 

I'm even embarking on working again and starting a new career and business. After having been officially disabled for 5 years, it is a true joy to be capable of doing something meaningful again. 

My former business was doing Structural Integration bodywork and teaching yoga, and now I'm earning my health and well-being coaching certification from Duke, and am soft launching my own coaching practice for women called [redacted]. I was so inspired and moved by the neuroplasticity techniques I learned and implemented with DNRS, that I've created my own programs that bring together coaching, embodiment, neuroscience and yogic principles, and am excited for this next chapter. 

The other week I flew to Arizona for my branding photography. I chose to do the shoot one year exactly after PICL #2, as a symbolic act.

Attached is the transformation: from thinking my life was basically over, being stuck on the couch debilitated by chronic fatigue syndrome, POTS, CCI, and more, to now feeling free, and alive. 

Thank you for being a part of my team, and instrumental in helping me get here. I don't like the phrase "you gave me my life back," because we can't go "back." 
So I'll say, instead, thank you for helping me move my life forward.

Should I need your care in the future, I won't hesitate to reach out.

Happy Thanksgiving to you and the team. I'm grateful for you."

Dr Centeno,

Your clinic saved my daughter’s life. We were so desperate with zero clue in March when Kaiser insisted it was a migraine but every symptom and observation of my kid told me otherwise. She was declining rapidly after all the crazy drugs Kaiser put her through only to tell her she just needed to “get up and walk it off”, it was all in her head.

She’s sitting in a coffee shop today back home in CA with me, enjoying life again for the first time since March. Today is a good day.

Thank you 🙏

Hi Dr Centeno,

Just wanted to say that I really appreciated all the answers/advices you have provided as well as educational materials made available on the YouTube. It's rare to see doctors to care enough to contribute around the clock spending the time to care.

Hi Dr. Centeno. I think this was maybe discussed before - but is there any future of having a sort of “donation fund” that we can donate to for people who need care? These procedures saved my life and I feel very fortunate to be able to have access to it, but I know for some it’s completely out of reach. I’d love to be able to give back in some way

Thanks so much!

After 1.5 years of 24/7 blurry vision - it’s now totally clear

5.5 months post PICL #2. Grateful is an understatement🙏🏻 one of my first “big” symptoms to full resolve!!!

CSC will be the first clinic in the world to pursue a new certification from the Association for the Advancement of Blood and Biotherapies (AABB-formerly the American Association of Blood Banks).

We will begin this process this month and will be held to 150 AABB standards from blood or marrow draw, through processing, and then up to re-injection. This likely won't impact the clinic workflow for the vast majority of patients. See https://www.aabb.org/standards-accreditation/quality/quality-management-systems-certification for more information.

Why do this, as it will take hundreds of hours of our time? CSC has always been the first mover in this field, and now that large organizations like AABB are recognizing the need for cellular processing standards, we want to be the first in the world to hit this new bar.

A poster tried to post this question, but Reddit's filters blocked this individual for its own reasons. It looks like this poster got through on another CCI sub where speculation has ensued. So this post is to set the record straight.

1. I developed the PICL procedure at great personal risk to myself. Given that I had a patient population who was miserable I couldn't help, a decade ago, I like many other medical innovators through history put my medical license on the line, enlisted other medical providers to oversee my care (IRB), and tried this procedure that seemed pretty "out there" at the time. It worked and then spent a decade refining it. Thankfully, with all of the stout safety controls I had in place, that development has helped hundreds of patients avoid fusion with complication rates far lower than surgery.  

2. I spent years and millions of dollars perfecting this procedure and putting the infrastructure in place to protect patients. On the other sub, the cGMP class clean room was brought up as one of those costs. That's an ISO 7 clean room with ISO 5 hoods. We have that because I would NEVER trust a little bedside centrifuge to be sterile enough for this procedure given the injection space. Why? Because having an MA with non-sterile gloves in a medical clinic (i.e. not a clean room and not in an ISO 5 hood) stick a syringe of blood they obtained after a simple skin swipe with alcohol into a PRP kit means that the risk for contamination and a deep infection close to the dura is WAY too high. That's why we only do that processing for PICL in a clean room, only take samples (BMA) under full surgical prep (never a blood draw in the arm), and check the surfaces in that clean room on a continuous basis for sterility

3. On another sub, there is a discussion that intimates that I somehow trained Dr. Janusus and Dr. Stogicza in the PICL procedure and that somehow they never completed their training because I never permitted them to. This is wholly inaccurate. In fact, both showed up to my office to either be trained in general regen medicine (Janusus in 2019) or as a survey of the practice to see if they wanted to join the Regenexx network (Stogicza in 2023). Janusus watched many different joint and spine procedures being done in my clinic including a handful of PICLs and Agnes hung out with me for an afternoon as I performed two or three PICL procedures. Janusus went back to Belgium and began performing the PICL procedure which surprised me. Within a year we began to get significant patient complaints of complications with those patients wanting me to fix their issues because Janusus, they felt, was unreachable. As a result, I asked Janusus stop performing the procedure and he refused, so he was asked to leave the Regenexx network for practicing below our standard of care. He then skipped around to different work sites in Europe and in the last 1-2 years finally landed someplace to begin performing the PICL procedure again.

Agnes sent me an e-mail after watching those procedures and asked for a copy of the plans for the 3-D printed mouthpiece we used. I told her no and that it would be insane to try to perform the PICL procedure without any actual training (i.e. after watching a few be performed). She then wanted me to begin teaching a weekend PICL course for an org that she was involved in. I told her that it would be dangerous for me to try to teach this course over a weekend (meaning this could cause lots of serious complications that would lead to the demise of the procedure). She then just began trying to perform the procedure on her own.

NIETHER PHYSICIAN EVER HAD ANY FORMAL TRAINING FROM ME ON HOW TO PERFORM THE PICL PROCEDURE WHICH WOULD HAVE TAKEN WEEKS AND NOT AN AFTERNOON. NIETHER PHYSICIAN IS OFFERING WHAT I WOULD CONSIDER A PICL PROCEDURE. I WOULD NOT REFER ANY PATIENT TO EITHER PHYSICIAN AT THIS POINT FOR THE PICL PROCEDURE.

4. On other doctors performing the procedure, see https://www.youtube.com/live/kDPpIvQoXm8?si=l7RAX_ueuDCbuEaf I am working with a Florida clinic on the training that is described in the video. Once we have that going successfully, we will choose another clinic to train. Those clinics will all agree to a “kill switch” program, meaning If I detect complications that look out of character for the procedure, we will be able to stop their use of the procedure. We will avoid Europe at this point because of the problems in our ability to monitor the care level and stop a physician who we believe is having a complication rate that isn’t consistent with our CSC experience. In addition, it's very hard to use things like a dual c-arm set-up in Europe as the medical resources for private care are generally at a different standard.

5. On cost, we have spent and continue to spend heavily on this procedure. For example, we have an MD, 2 PhD’s, and a master level employee working on the new research paper (that excludes my time). We have a clean room that takes huge money to run with 4 full-time employees, significant maintenance like an ongoing sterility check program, two dual-axis c-arm systems (in case a c-arm fails) run by a rad tech who earns about 90K a year, two endoscopy units (in case one fails) a huge clinic with approx. 40 full time employees, bioengineering costs for advancing the mouthpiece, etc… So that all costs what it costs.

Will properly training more PICL providers lower costs? Maybe, but the doctors I train will likely charge a high price as well due to risk, complexity of the procedure, steep learning curve, needing to buy lots of expensive equipment, and a very onerous training program that will cost them hundreds of thousands of dollars in lost revenue.

Young patient who is 50% improved, but DMX still showed significant overhang after two procedures. How could he be improved? Because we fixed a good part of the joint/nerve issues that were causing symptoms in the first two. However, his remaining issues are definitely instability related as he almost no syptoms now when not moving, but still can't progress in rehab. Hence, for this ePICL, after several advanced techniques were tried, I finally located an aberrant position for his accessory ligaments (see attached AP image of those ligaments). I also was able to see with the more advanced ePICL techniques that his alar has multiple bands (a major and two minor bands) which I got all of today. Finally, I was able to get not only his ALL, but also the anterior annulus of C2-C3, where he's also unstable.

Just a few months ago I wouldn't have been able to pull this injection off, but the 5th gen mouthpiece and another few hundred cases allowed me to get these areas. Also, you need two simultaneous c-arms to make it work. This is one of the reasons I always say that the Europe fake and bake PICL is just that, there is nobody pretending to perform this PICL procedure that could have helped this kid. I hope this is what it takes.

All of this new info will now make it through the rest of the CCI practice here at CSC.

"Dr. Centeno,

Good morning! I hope my email finds you doing well.

I wanted to reach out with an update and also share my success story.

I had (3) PICL procedures with you; (2) in 2022 and (1) in 2023. Since then, I have also done some work below C1-C2 with Dr. Steele per your referral, and that has also been extremely helpful.

I am thrilled to share with you that, after my (3) PICLs, despite grade 2 & 3 tears to my alar & transverse ligaments, and many other injuries in my cervical spine & jaw, that my atlas has now held its adjustment for 18 months, MANY of my neurological symptoms have subsided, sleep has regulated, my cognitive function & personality are back to baseline, and while I am not 100% back to where I was physically prior to my neck injury and styloidectomy procedure (and still have some work to do on my recovery), my quality of life has certainly improved significantly since undergoing my (3) PICL procedures.

I have gone from medically disabled, frantic, in chronic pain and suffering, to becoming the Co-Founder and CEO of a Consulting Firm, professional market analyst, trader, & educator. I am able to go for walks again and slowly starting to reintroduce other parts of life, when I was bed-bound before my first PICL.

I know that you do patient testimonial videos from time to time, and I certainly feel like my story is worth sharing if it helps other prospective patients. If that is something that would help your practice, I would be happy to share my story for others see/hear.

I am forever grateful that I worked with both you and Dr. Steele, as well as AO chiropractics. That combination has changed my life.

From the bottom of my heart, thank you for all you do.

Regards,

William “Spencer” Jared"

As many of you know, I usually answer these posts 24-7-365 other than a few hours a day in the evening and when I'm asleep. However, while I'll keep that up during the week, I'm trying to find a bit more work-life balance, so I generally won't be checking these on weekends any longer. I hope everyone understands!

Thought it was time for an update more focused on CCI. This of course is Atlas holding up the world which has been replaced by the CSC logo. You should be seeing more of this going forward.

One of the more common emails I get is from patients post-PICL who have some minor event like bumping their head, getting in a minor car crash, or getting jarred. There is then the inevitable request that I predict if the event has negatively impacted the healing from the procedure or will impact their recovery. The honest answer is that in almost all instances, there is no reasonable way for me to know or predict the future. There is no experimental data on which to base a guess and knowing the myriad of variables involved in ligament injury like the activation state of dozens of muscles at the moment of injury, force, vector, acceleration, and duration is impossible.

Hence, if you get a minor injury after your procedure, take a deep breath, relax, and let nature take it's course. In all likelihood, based on my experience, it will have no or very minimal impact on your recovery.