Comparison of interlaminar CT-guided epidural platelet-rich plasma versus steroid injection in patients with lumbar radicular pain

Bise, Sylvain; Dallaudière, B.; Pesquer, Lionel; Pedram, M.; Meyer, P.; Antoun, Myriame Bou; Hocquelet, Arnaud; Silvestre, Alain

doi:10.1007/s00330-020-06733-9

Cited by 19 publications

(35 citation statements)

References 58 publications

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“…Two studies found no difference in VAS reduction between the two groups at a final follow-up of six to 12 weeks [39][40]. Two studies reported baseline and final Oswestry Disability Index (ODI) as secondary outcome measures [36,40]. Both studies found that both groups led to a statistically significant reduction in ODI.…”

Section: Resultsmentioning

confidence: 99%

“…These five studies contained: 242 patients either treated with (i) PRP injection (114 patients) or (ii) corticosteroid injection (128 patients) [36][37][38][39][40]. Three studies included patients with lumbar spondylosis [36,38,40], and two studies included patients with sacroiliac arthropathy (Table 1) [37,39]. PRP was obtained in all studies by centrifugation of 30 to 200 mL of autologous blood to perform imageguided injections of 0.5 to 16.5 mL of PRP into the target site (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…PRP was obtained in all studies by centrifugation of 30 to 200 mL of autologous blood to perform imageguided injections of 0.5 to 16.5 mL of PRP into the target site (Table 2). Two studies performed epidural injections [38,40], two studies performed sacroiliac joint injections [37,39], and one study performed lumbar facet joint injections [36]. None of the studies recorded the use of post-injection cryotherapy.…”

Section: Resultsmentioning

confidence: 99%

“…No study compared leukocyte-poor PRP to leukocyte-rich PRP. However, two studies reported using leukocyte-poor PRP [37,40], and one study reported using leukocyte-rich PRP [38]. [38].…”

Section: Resultsmentioning

confidence: 99%

“…Three studies found a higher reduction in VAS among PRP patients as compared with corticosteroid patients at a follow-up of three to six months that was statistically significant [36][37][38]. Two studies found no difference in VAS reduction between the two groups at a final follow-up of six to 12 weeks [39][40]. Two studies reported baseline and final Oswestry Disability Index (ODI) as secondary outcome measures [36,40].…”

Section: Resultsmentioning

confidence: 99%

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Platelet-Rich Plasma Versus Corticosteroid Injection for Lumbar Spondylosis and Sacroiliac Arthropathy: A Systematic Review of Comparative Studies

Ling

Wininger

Hirase

2021

Cureus

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This systematic review compares clinical outcomes between platelet-rich plasma (PRP) and corticosteroid injections for the treatment of lumbar spondylosis and sacroiliac arthropathy. A systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) and performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using the Pubmed, SCOPUS, and Ovid MEDLINE databases. All level I-III evidence comparative studies published in the English language investigating the clinical outcomes between PRP and corticosteroid injections for the treatment of lumbar spondylosis and sacroiliac arthropathy were included. Five studies (242 patients, 114 PRP, 128 corticosteroid) were analyzed. One randomized study was level I evidence, two randomized studies were level II, and two non-randomized studies were level III. Final follow-up ranged from six weeks to six months. Four studies found that both PRP and corticosteroid treatment led to a statistically significant reduction in the visual analog scale (VAS). One found that only the PRP group led to a statistically significant reduction in VAS. Three studies found more significant improvements in one or more clinical outcome scores among PRP patients as compared with corticosteroid patients at the three- to six-month follow-up. Two studies found no difference in outcome score improvements between the two groups at six- to 12-week follow-up. There were no reports of major complications. There were no significant differences in minor complication rates between the two groups. In conclusion, both PRP and corticosteroid injections are safe and effective options for the treatment of lumbar spondylosis and sacroiliac arthropathy. There is some evidence that PRP injection is a more effective option at long-term follow-up compared with corticosteroid injection. Further randomized controlled trials with longer-term follow-up are necessary to compare its long-term efficacy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…No study compared leukocyte-poor PRP to leukocyte-rich PRP. However, two studies reported using leukocyte-poor PRP [37,40], and one study reported using leukocyte-rich PRP [38]. [38].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Platelet-Rich Plasma Versus Corticosteroid Injection for Lumbar Spondylosis and Sacroiliac Arthropathy: A Systematic Review of Comparative Studies

Ling

Wininger

Hirase

2021

Cureus

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Platelet‐rich plasma and cytokines in neuropathic pain: A narrative review and a clinical perspective

Bohren

Timbolschi

Müller

et al. 2021

European Journal of Pain

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Background and Objective Neuropathic pain arises as a direct consequence of a lesion or disease affecting the somatosensory system. A number of preclinical studies have provided evidence for the involvement of cytokines, predominantly secreted by a variety of immune cells and by glial cells from the nervous system, in neuropathic pain conditions. Clinical trials and the use of anti‐cytokine drugs in different neuropathic aetiologies support the relevance of cytokines as treatment targets. However, the use of such drugs, in particularly biotherapies, can provoke notable adverse effects. Moreover, it is challenging to select one given cytokine as a target, among the various neuropathic pain conditions. It could thus be of interest to target other proteins, such as growth factors, in order to act more widely on the neuroinflammation network. Thus, platelet‐rich plasma (PRP), an autologous blood concentrate, is known to contain a natural concentration of growth factors and immune system messengers and is widely used in the clinical setting for tissue regeneration and repair. Database and Data Treatment In the present review, we critically assess the current knowledge on cytokines in neuropathic pain by taking into consideration both human studies and animal models. Results This analysis of the literature highlights the pathophysiological importance of cytokines. We particularly highlight the concept of time‐ and tissue‐dependent cytokine activation during neuropathic pain conditions. Conclusion Thus, direct or indirect cytokines modulation with biotherapies or growth factors appears relevant. In addition, we discuss the therapeutic potential of localized injection of PRP as neuropathic pain treatment by pointing out the possible link between cytokines and the action of PRP. Significance Preclinical and clinical studies highlight the idea of a cytokine imbalance in the development and maintenance of neuropathic pain. Clinical trials with anticytokine drugs are encouraging but are limited by a 'cytokine candidate approach' and adverse effect of biotherapies. PRP, containing various growth factors, is a new therapeutic used in regenerative medicine. Growth factors can be also considered as modulators of cytokine balance. Here, we emphasize a potential therapeutic effect of PRP on cytokine imbalance in neuropathic pain. We also underline the clinical interest of the use of PRP, not only for its therapeutic effect but also for its safety of use.

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Spinal Regenerative Medicine

Gross¹

2022

Musculoskeletal Ultrasound-Guided Regenerative Medicine

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Comparison of interlaminar CT-guided epidural platelet-rich plasma versus steroid injection in patients with lumbar radicular pain

Cited by 19 publications

References 58 publications

Platelet-Rich Plasma Versus Corticosteroid Injection for Lumbar Spondylosis and Sacroiliac Arthropathy: A Systematic Review of Comparative Studies

Platelet-Rich Plasma Versus Corticosteroid Injection for Lumbar Spondylosis and Sacroiliac Arthropathy: A Systematic Review of Comparative Studies

Platelet‐rich plasma and cytokines in neuropathic pain: A narrative review and a clinical perspective

Spinal Regenerative Medicine

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