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This protocol outlines the investigational use of extracellular matrix–derived biologics (EXM) in combination with PV-MAX exosome therapy as an adjunctive regenerative approach for patients with spina bifida. The goal is to support neural signaling, reduce neuroinflammation, and promote systemic repair mechanisms. This therapy is not intended to cure spina bifida and is considered investigational and off-label.
Diagnosed spina bifida (myelomeningocele, meningocele, or spina bifida occulta)
Pediatric or adult patients per clinic policy
Medically stable without active infection
Informed consent obtained
Contraindications
Active systemic infection
Known hypersensitivity to biologic components
Active malignancy
Pregnancy unless approved by Medical Director
Coagulopathy or anticoagulation contraindicating IM injection
EXM: 2 cc total, administered intramuscularly (IM)
PV-MAX: 3 cc total, administered intramuscularly (IM)
Total Injectate Volume: 5 cc
Biologics should be thawed according to manufacturer specifications. Glycerol-based products do not require washing. Products must be used within 15–30 minutes post-thaw. Strict sterile technique must be maintained throughout preparation and administration.
Preferred injection site is the gluteal musculature due to volume tolerance and systemic absorption. Alternative sites include the deltoid (maximum 2 cc per deltoid).
Recommended Injection Distribution:
EXM: 1 cc per glute bilaterally
PV-MAX: 1.5 cc per glute bilaterally
Use a 22–25 gauge needle for IM injection.Aspirate prior to injection and inject slowly. Observe the patient for 15–30 minutes post-procedure.
This protocol represents off-label and investigational use of biologic products. All treatments must comply with applicable state and federal regulations, institutional policies, and informed consent requirements. No claims of disease cure are made
Potential risks include injection site discomfort, bruising, or transient inflammatory response. No known tumorigenic risk has been identified based on the acellular nature of the biologics; however, long-term outcomes remain under investigation.
All treatments must be ordered and supervised by a licensed physician experienced in regenerative medicine.

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