Autologous Platelet Rich Plasma for Neck and Lower Back Pain Secondary to Spinal Disc Herniation: Midterm Results

<sec><title>Study Design</title>Preliminary clinical trial.</sec><sec><title>Purpose</title>To determine the safety and initial efficacy of intradiscal injection of autologous platelet-rich plasma (PRP) releasate in patients with discogenic low back pain.</sec><sec><title>Overview of Literature</title>PRP, which is comprised of autologous growth factors and cytokines, has been widely used in the clinical setting for tissue regeneration and repair. PRP has been shown <italic>in vitro</italic> and <italic>in vivo</italic> to potentially stimulate intervertebral disc matrix metabolism.</sec><sec><title>Methods</title>Inclusion criteria for this study included chronic low back pain without leg pain for more than 3 months; one or more lumbar discs (L3/L4 to L5/S1) with evidence of degeneration, as indicated via magnetic resonance imaging (MRI); and at least one symptomatic disc, confirmed using standardized provocative discography. PRP releasate, isolated from clotted PRP, was injected into the center of the nucleus pulposus. Outcome measures included the use of a visual analog scale (VAS) and the Roland-Morris Disability Questionnaire (RDQ), as well as X-ray and MRI (T2-quantification).</sec><sec><title>Results</title>Data were analyzed from 14 patients (8 men and 6 women; mean age, 33.8 years). The average follow-up period was 10 months. Following treatment, no patient experienced adverse events or significant narrowing of disc height. The mean pain scores before treatment (VAS, 7.5±1.3; RDQ, 12.6±4.1) were significantly decreased at one month, and this was generally sustained throughout the observation period (6 months after treatment: VAS, 3.2±2.4, RDQ; 3.6±4.5 and 12 months: VAS, 2.9±2.8; RDQ, 2.8±3.9; <italic>p</italic><0.01, respectively). The mean T2 values did not significantly change after treatment.</sec><sec><title>Conclusions</title>We demonstrated that intradiscal injection of autologous PRP releasate in patients with low back pain was safe, with no adverse events observed during follow-up. Future randomized controlled clinical studies should be performed to systematically evaluate the effects of this therapy.</sec>

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Factors for Predicting Favorable Outcome of Percutaneous Epidural Adhesiolysis for Lumbar Disc Herniation

Pain Research and Management ◽

10.1155/2017/1494538 ◽

2017 ◽

Vol 2017 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Sang Ho Moon ◽

Jae Il Lee ◽

Hyun Seok Cho ◽

Jin Woo Shin ◽

Won Uk Koh

Keyword(s):

Back Pain ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lower Back Pain ◽

Rating Scale ◽

Lumbar Disc ◽

Multivariate Logistic Regression Analysis ◽

Long Term Outcome ◽

Lower Back ◽

High Intensity Zone

Background. Lower back pain is a common reason for disability and the most common cause is lumbar disc herniation. Percutaneous epidural adhesiolysis has been applied to relieve pain and increase the functional capacity of patients who present this condition.Objectives. In this study, we retrospectively evaluated the factors which predict the outcome of percutaneous epidural adhesiolysis in patients who were diagnosed with lumbar disc herniation.Methods. Electronic medical records of patients diagnosed with lumbar disc herniation who have received percutaneous epidural adhesiolysis treatment were reviewed. The primary outcome was the factors that were associated with substantial response of ≥4 points or ≥50% of pain relief in the numerical rating scale pain score 12 months after the treatment.Results. Multivariate logistic regression analysis demonstrated that the presence of high-intensity zone (HIZ) at magnetic resonance imaging was a predictor of substantial response to percutaneous epidural adhesiolysis for 12 months (P=0.007). The presence of a condition involving the vertebral foramen was a predictor for unsuccessful response after 12 months (P=0.02).Discussion and Conclusion. The presence of HIZ was a predictor of favorable long-term outcome after percutaneous epidural adhesiolysis for the treatment of lower back pain with radicular pain caused by lumbar disc herniation.

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Treatment of unresolved lower back pain with platelet-rich plasma injections

Cogent Medicine ◽

10.1080/2331205x.2019.1581449 ◽

2019 ◽

Vol 6 (1) ◽

pp. 1581449 ◽

Cited By ~ 1

Author(s):

Marc Darrow ◽

Brent Shaw ◽

Schmidt Nicholas ◽

Xian Li ◽

Gabrielle Boeger ◽

...

Keyword(s):

Back Pain ◽

Lower Back Pain ◽

Platelet Rich Plasma ◽

Lower Back

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The Effect of Intradiscal Platelet-Rich Plasma Injection for Management of Discogenic Lower Back Pain: A Meta-Analysis

Journal of Pain Research ◽

10.2147/jpr.s292335 ◽

2021 ◽

Vol Volume 14 ◽

pp. 505-512

Author(s):

Min Cheol Chang ◽

Donghwi Park

Keyword(s):

Back Pain ◽

Lower Back Pain ◽

Platelet Rich Plasma ◽

Meta Analysis ◽

Lower Back ◽

Plasma Injection

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A New Technique for the Treatment of Lumbar Facet Joint Syndrome Using Intra-articular Injection with Autologous Platelet Rich Plasma

January 2018 - Pain Physician ◽

10.36076/ppj/2016.19.617 ◽

2016 ◽

Vol 8;19 (8;11) ◽

pp. 617-625

Author(s):

Qinyi Liu

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Facet Joint ◽

Platelet Rich Plasma ◽

Low Back ◽

Lumbar Facet Joint ◽

Autologous Platelet Rich Plasma ◽

Lumbar Facet ◽

Autologous Platelet

Background and Objectives: Lumbar facet joint syndrome is currently suggested to be a main source of axial low back pain, and a large portion of axial low back pain is caused by disorders in lumbar facet joints. Intra-articular injection is one of the most common treatment methods in the early clinical application. Therefore, we attempt to seek a new injectable material, autologous platelet rich plasma (PRP), to treat lumbar facet syndrome, as well as to assess its therapeutic effectiveness and safety. Study Design: A prospective clinic evaluation. Setting: The outpatient clinic of a single academic medical center. Methods: Total 19 patients with lumbar facet joint syndrome (8 men, 11 women; mean ages: 52.53 ± 6.79 years, range: 38 – 62 years) were enrolled to receive lumbar facet joint injection with autologous PRP under x-ray fluoroscopic control. Patients were followed up immediately, at one week, one month, 2 months, and 3 months following treatment, and the elements of this analysis included low back pain visual analogue scale (VAS) at rest and during flexion, Roland-Morris Disability Questionnaire (RMQ), Oswestry Disability Index (ODI), and modified MacNab criteria for the pain relief. Results: All the 19 patients completed the intra-articular injections with autologous PRP successfully. At one week after treatment, low back pain reduced significantly compared with prior to treatment both at rest and during flexion. The outcomes were assessed as “good” or “excellent” for 9 patients (47.37%) immediately after treatment, 14 patients (73.68%) at one week, 15 patients (78.95%) at one month, 15 patients (78.95%) at 2 months, and 15 patients (78.95%) at 3 months. Statistically significant differences were observed based on RMQ and a more than 10% improvement in lumbar functional capacity was observed based on ODI between pre-treatment and post-treatment. In addition, there were no severe relevant complications during the whole process of injection and follow-up period. Limitations: A control group and the curative effect observations with longer follow-up may lead to a more convincing result for our study. Conclusions: In the short-term period of 3 months, the new technique of lumbar facet joint injection with autologous PRP is effective and safe for patients with lumbar facet joint syndrome. Key words: Low back pain, lumbar facet joint syndrome, autologous platelet rich plasma, intra-articular injection

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