Clinical outcomes following intradiscal injections of higher-concentration platelet-rich plasma in patients with chronic lumbar discogenic pain

Lutz, Cole; Cheng, Jennifer; Prysak, Meredith H.; Zukofsky, Tyler A; Rothman, Rachel; Lutz, Gregory E.

doi:10.1007/s00264-022-05389-y

Cited by 18 publications

(10 citation statements)

References 22 publications

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“…Noteworthy, intradiscal PRP injections led to the conclusion that pain killing was significantly correlated with PRP platelet concentrations [ 50 ], where higher platelet counts (>1.0 × 10 6 /μL), triggered a more promising painkilling response. These findings are in agreement with the findings Lutz and associates [ 34 ]. They determined that a high dose of platelets (>10 times baseline platelet level) significantly reduced pain following intradiscal injections.…”

Section: Clinical Prp Recipe Considerationssupporting

confidence: 94%

“…At present, C-PRP formulations have been shown to lead to significant positive patient outcomes when used in numerous pathologies [ 32 , 33 , 34 , 35 , 36 ]. C-PRP is a complex composition of autologous concentrated platelets, with the option of adding or removing other cellular components, in a small volume of plasma, acquired from a fraction of centrifuged peripheral blood.…”

Section: Clinical Prp Recipe Considerationsmentioning

confidence: 99%

“…They observed a consistent clinical effect regarding function, pain, and inflammatory markers after a single injection over a 12-month period. Additionally, other MSK oriented PRP studies have identified platelet dose and bioformulations as key characteristics that contribute to consistent analgesic effects [ 34 , 44 ].…”

Section: Clinical Prp Recipe Considerationsmentioning

confidence: 99%

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Modifying Orthobiological PRP Therapies Are Imperative for the Advancement of Treatment Outcomes in Musculoskeletal Pathologies

et al. 2022

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Autologous biological cellular preparations have materialized as a growing area of medical advancement in interventional (orthopedic) practices and surgical interventions to provide an optimal tissue healing environment, particularly in tissues where standard healing is disrupted and repair and ultimately restoration of function is at risk. These cellular therapies are often referred to as orthobiologics and are derived from patient’s own tissues to prepare point of care platelet-rich plasma (PRP), bone marrow concentrate (BMC), and adipose tissue concentrate (ATC). Orthobiological preparations are biological materials comprised of a wide variety of cell populations, cytokines, growth factors, molecules, and signaling cells. They can modulate and influence many other resident cells after they have been administered in specific diseased microenvironments. Jointly, the various orthobiological cell preparations are proficient to counteract persistent inflammation, respond to catabolic reactions, and reinstate tissue homeostasis. Ultimately, precisely delivered orthobiologics with a proper dose and bioformulation will contribute to tissue repair. Progress has been made in understanding orthobiological technologies where the safety and relatively easy manipulation of orthobiological treatment tools has been demonstrated in clinical applications. Although more positive than negative patient outcome results have been registered in the literature, definitive and accepted standards to prepare specific cellular orthobiologics are still lacking. To promote significant and consistent clinical outcomes, we will present a review of methods for implementing dosing strategies, using bioformulations tailored to the pathoanatomic process of the tissue, and adopting variable preparation and injection volume policies. By optimizing the dose and specificity of orthobiologics, local cellular synergistic behavior will increase, potentially leading to better pain killing effects, effective immunomodulation, control of inflammation, and (neo) angiogenesis, ultimately contributing to functionally restored body movement patterns.

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Section: Clinical Prp Recipe Considerationssupporting

confidence: 94%

Section: Clinical Prp Recipe Considerationsmentioning

confidence: 99%

Section: Clinical Prp Recipe Considerationsmentioning

confidence: 99%

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Modifying Orthobiological PRP Therapies Are Imperative for the Advancement of Treatment Outcomes in Musculoskeletal Pathologies

et al. 2022

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“…Similar painkilling observations were reported in a systematic review regarding PRP utilization in orthopedic surgical and non-surgical spine procedures [95,96]. In another study, higher platelet concentrations were significantly associated with greater analgesic responses and higher post treatment outcome satisfaction [97]. The impact of platelet concentration on painkilling was also demonstrated in a small animal study.…”

Section: Analgesic Effectssupporting

confidence: 80%

Profound Properties of Protein Rich Platelet Concentrate Matrices as Novel Multi-Purpose Biological Platforms in Tissue Repair, Regeneration, and Wound Healing

Everts,

Lana,

Alexander

et al. 2024

Preprint

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Autologous platelet-rich plasma (PRP) preparations are prepared at point of care. Centrifugation cellular density separation sequesters a fresh unit of blood into three main fractions: a platelet-poor plasma (PPP) fraction, a stratum rich in platelets (platelet concentrate) and, bioformulation dependent, also leukocyte and erythrocyte fractions. The employment of autologous platelet concentrates facilitates the biological potential to accelerate and support in numerous cellular activities that can lead to tissue repair, tissue regeneration, wound healing, and ultimately functional structural repair. Normally, after PRP preparation the PPP fraction is discarded. One of the less well known, but equally important features of PPP is that particular growth factors (GFs) are not abundantly present in PRP, as they reside outside the platelet alpha granules. Precisely, insulin-like growth factor-1 (IGF-1) and hepatocyte growth factor (HGF) are mainly present in the PPP fraction. In addition to their roles as angiogenesis activators, these plasma-based GFs are also known to inhibit inflammation, fibrosis, and they promote keratinocyte migration and support in tissue repair and wound healing. Additionally, PPP is known for the presence of exosomes and other macrovesicles, exerting cell-cell communication and cell signaling. Newly developed ultrafiltration technologies incorporate PPP processing methods by eliminating in a fast and efficient manner plasma water, cytokines, molecules, and plasma proteins with a molecular mass (weight) less than the pore size of the fibers. Consequently, a viable and viscous protein concentrate of functional, total proteins, like fibrinogen, albumin, and alpha-2-macroglobulin is created. Consolidating a small volume of high platelet concentrate with a small volume of highly concentrated protein-rich PPP creates a protein rich platelet concentrate (PRPC) biological preparation. After the activation of proteins, mainly fibrinogen, the PRPC matrix retains and facilitates interactions between invading resident cells, like macrophages, fibroblast, and mesenchymal stem cells (MSCs), and the embedded concentrated PRP cells and molecules. The administered PRPC biologic will ultimately undergo fibrinolysis, leading to a sustained release of concentrated cells and molecules that have been retained in the PRPC matrix until the matrix is dissolved. We will discuss the unique biological and tissue reparative and regenerative properties of PRPC matrix.

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“…Con una mejoría mayor en el grupo de concentración > 10×. 18 2022. Schneider y su grupo determinaron la efectividad de los productos biológicos intradiscales para tratar el dolor lum- bar discogénico.…”

Section: Pdgfunclassified

Revisión bibliográfica de la eficacia del tratamiento con plasma rico en plaquetas en hernia de disco lumbar

Guerrero-Molina,

Cruz-Álvarez,

Tenopala-Villegas

2023

Acta Ortopédica Mexicana

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Platelet-rich plasma (PRP) is an autologous blood product containing growth factors and proteins, widely employed in the clinical setting for tissue repair. Robust evidence in basic science literature has facilitated clinical research involving PRP for patients with disc disease and lumbar pain. Degenerative disc disease (DDD) has been identified as a significant contributor to lower back pain, with approximately 40% of patients under 30 and 90% of those over 50 experiencing lumbar pain showing MRI findings consistent with degenerative changes in intervertebral discs. Regenerative medicine within the disc has primarily been studied in patients with chronic, untreatable lumbar pain. Objective: to understand the available evidence regarding the efficacy of PRP in lumbar disc herniation. By understanding the scientific evidence supporting PRP as a lumbar disc herniation treatment, a research project can be developed, providing the theoretical foundation for implementing this therapy in the Mexican population. A search was conducted using PUBMED, ClinicalKey (Elsevier), Medscape, Science Direct, and Google Scholar databases. Conclusions: despite promising results in several studies on intradiscal PRP injection, small sample sizes and non-standardized graft preparation procedures have hindered these research efforts.

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Clinical outcomes following intradiscal injections of higher-concentration platelet-rich plasma in patients with chronic lumbar discogenic pain

Cited by 18 publications

References 22 publications

Modifying Orthobiological PRP Therapies Are Imperative for the Advancement of Treatment Outcomes in Musculoskeletal Pathologies

Modifying Orthobiological PRP Therapies Are Imperative for the Advancement of Treatment Outcomes in Musculoskeletal Pathologies

Profound Properties of Protein Rich Platelet Concentrate Matrices as Novel Multi-Purpose Biological Platforms in Tissue Repair, Regeneration, and Wound Healing

Revisión bibliográfica de la eficacia del tratamiento con plasma rico en plaquetas en hernia de disco lumbar

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