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

Cameron, Julian A; Thielen, Katelyn M

doi:10.21767/2471-8173.100030

Cited by 9 publications

(7 citation statements)

References 21 publications

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“…One RTC study was still in the peer-review process at the time of analysis and was included as a personal communication to the author [73]. Additionally, the case series involved a total of 1759 patients, with studies focusing on intradiscal (160 patients) [34,56,[79][80][81][82][83], epidural (810 patients) [64,[84][85][86][87][88], facet injection (109 patients) [89][90][91], and lumbar muscles (171 patients) [61,92] or simultaneous application in multiple targets (509 patients) [10,[93][94][95][96][97][98][99][100]. The RCTs compared the effect of PRP with saline, steroids, contrast agent, hyaluronic acid, or ozone.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review of Platelet-Rich Plasma for Low Back Pain

Machado,

Soares,

Vianna de Abreu

et al. 2023

Biomedicines

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Background: Low back pain (LBP) has a high economic burden and is strongly related to the degenerative process of the spine, especially in the intervertebral disc and of the facet joints. Numerous treatment modalities have been proposed for the management of LBP, and the use of platelet-rich plasma (PRP) has emerged as an innovative therapeutic option for degenerative disease of the spine. The present study aims to evaluate the efficacy of PRP injections in managing low back pain. Methods: We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, a registered at PROSPERO Systematic Reviews Platform, under number CRD42021268491. The PubMed, Web of Science, and Scopus databases were searched to identify relevant articles, along with hand searching to identify gray literature articles, with no language restrictions. Randomized clinical trials (RCTs), nonrandomized trials (NRTs), and case series (CSs) with more than 10 patients were considered eligible. The quality assessment and the risk of bias of the randomized clinical trials were evaluated using the RoB II tool. An evaluation of the description of the preparation methods was performed using an adapted version of the MIBO checklist. Results: An electronic database search resulted in 2324 articles, and after the exclusion of noneligible articles, 13 RCTs and 27 NRTs or CSs were analyzed. Of the 13 RCTs, 11 found favorable results in comparison to the control group in pain and disability, one showed no superiority to the control group, and one was discontinued because of the lack of therapeutic effect at eight-week evaluation. Description of the PRP preparation techniques were found in almost all papers. The overall risk of bias was considered high in 2 papers and low in 11. An adapted MIBO checklist showed a 72.7% compliance rate in the selected areas. Conclusions: In this systematic review, we analyzed articles from English, Spanish and Russian language, from large databases and grey literature. PRP was in general an effective and safe treatment for degenerative LPB. Positive results were found in almost studies, a small number of adverse events were related, the risk of bias of the RCTs was low. Based on the evaluation of the included studies, we graded as level II the quality of the evidence supporting the use of PRP in LBP. Large-scale, multicenter RCTs are still needed to confirm these findings.

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Section: Resultsmentioning

confidence: 99%

Systematic Review of Platelet-Rich Plasma for Low Back Pain

Machado,

Soares,

Vianna de Abreu

et al. 2023

Biomedicines

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“…Autologous platelet-rich plasma injections have been shown to be successful in treating 87% of patients with spinal disc herniation and the symptomatic improvement had durable effects up to 8 years postoperatively [ 7 ]. In a follow-up assessment of patients who received intradiscal platelet-rich plasma (PRP) injections in a randomized controlled trial for moderate-to-severe lumbar discogenic pain, clinically significant improvements in pain and function at 5–9 years postinjection were demonstrated [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Novel Ultrasound-Guided Cervical Intervertebral Disc Injection of Platelet-Rich Plasma for Cervicodiscogenic Pain: A Case Report and Technical Note

et al. 2022

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Ultrasound-guided needle placement into the cervical intervertebral discs using a lateral-to-medial approach is reportedly possible. Clinically, however, patients commonly present with very high uncovertebral joints or narrowed intervertebral spaces, making the method difficult or impossible. This report presents a novel ultrasound-guided needle placement technique to the cervical intervertebral discs using a more medial approach between the trachea/thyroid gland and the carotid sheath. A patient presented with neck pain radiating to the right shoulder and right-sided interscapular regions that affected his sleep and daily functioning. Physiotherapy, selective nerve root block, and percutaneous endoscopic right C7 laminotomy did not sufficiently improve his condition, which progressed to bilateral interscapular and bilateral shoulder pain. Provocative discography was performed with injection of leukocyte-poor and red blood cell-poor platelet-rich plasma to provoke the discogenic pain, which was treated with platelet-rich plasma mixed with lidocaine. The patient recovered well. A month later, there was a significant decrease in the neck disability index score from the initial 28/50 to 14, and there was a further decrease to 5 after 2 months. In conclusion, this medial approach of ultrasound-guided cervical disc needle placement is feasible, even in patients where disc access by previously described approaches is impossible.

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“…Cameron and Thielen86 reported that PRP injected in a circumferential manner subfascially into the lateral masses, facet joints, and the other areas around the posterior spine contributed to a significant improvement of VAS by 77%. Sixty-eight percentage of the patients reported more than a 75% improvement of symptoms.…”

Section: Clinical Studies Of Prp For Lbp Patientsmentioning

confidence: 99%

<p>Platelet-rich plasma in the management of chronic low back pain: a critical review</p>

Akeda¹,

Yamada²,

Linn³

et al. 2019

JPR

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Low back pain (LBP) is now regarded as the first cause of disability worldwide and should be a priority for future research on prevention and therapy. Intervertebral disc (IVD) degeneration is an important pathogenesis of LBP. Platelet-rich plasma (PRP) is an autologous blood concentrate that contains a natural concentration of autologous growth factors and cytokines and is currently widely used in the clinical setting for tissue regeneration and repair. PRP has great potential to stimulate cell proliferation and metabolic activity of IVD cells in vitro. Several animal studies have shown that the injection of PRP into degenerated IVDs is effective in restoring structural changes (IVD height) and improving the matrix integrity of degenerated IVDs as evaluated by magnetic resonance imaging (MRI) and histology. The results of this basic research have shown the great possibility that PRP has significant biological effects for tissue repair to counteract IVD degeneration. Clinical studies for evaluating the effects of the injection of PRP into degenerated IVDs for patients with discogenic LBP have been reviewed. Although there was only one double-blind randomized controlled trial, all the studies reported that PRP was safe and effective in reducing back pain. While the clinical evidence of tissue repair of IVDs by PRP treatment is currently lacking, there is a great possibility that the application of PRP has the potential to lead to a feasible intradiscal therapy for the treatment of degenerative disc diseases. Further large-scale studies may be required to confirm the clinical evidence of PRP for the treatment of discogenic LBP.

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

Cited by 9 publications

References 21 publications

Systematic Review of Platelet-Rich Plasma for Low Back Pain

Systematic Review of Platelet-Rich Plasma for Low Back Pain

Novel Ultrasound-Guided Cervical Intervertebral Disc Injection of Platelet-Rich Plasma for Cervicodiscogenic Pain: A Case Report and Technical Note

<p>Platelet-rich plasma in the management of chronic low back pain: a critical review</p>

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