Does the Intradiscal Injection of Platelet Rich Plasma Have Any Beneficial Role in the Management of Lumbar Disc Disease?

Muthu, Sathish; Jeyaraman, Madhan; Chellamuthu, Girinivasan; Jeyaraman, Naveen; Jain, Rashmi; Khanna, Manish

doi:10.1177/2192568221998367

Cited by 17 publications

(16 citation statements)

References 53 publications

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“…Third, our study involved the use of PRPr [18] but not PRP itself. Therefore, it is possible that the efficacy might differ between PRPr and other variations of PRPs [16].…”

Section: Discussionmentioning

confidence: 99%

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Platelet-Rich Plasma Releasate versus Corticosteroid for the Treatment of Discogenic Low Back Pain: A Double-Blind Randomized Controlled Trial

Akeda

Ohishi

Takegami

et al. 2022

JCM

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Clinical application of platelet-rich plasma is gaining popularity in treating low back pain (LBP). This study investigated the efficacy and safety of platelet-rich plasma releasate (PRPr) injection into degenerated discs of patients with discogenic LBP. A randomized, double-blind, active-controlled clinical trial was conducted. Sixteen patients with discogenic LBP received an intradiscal injection of either autologous PRPr or corticosteroid (CS). Patients in both groups who wished to have PRPr treatment received an optional injection of PRPr eight weeks later. The primary outcome was change in VAS from baseline at eight weeks. Secondary outcomes were pain, disability, quality of life (QOL), image analyses of disc degeneration, and safety for up to 60 weeks. The VAS change at eight weeks did not significantly differ between the two groups. Fifteen patients received the optional injection. Compared to the CS group, the PRPr group had a significantly improved disability score at 26 weeks and walking ability scores at four and eight weeks. Radiographic disc height and MRI grading score were unchanged from baseline. PRPr caused no clinically important adverse events. PRPr injection showed clinically significant improvements in LBP intensity equal to that of CS. PRPr treatment relieved pain, and improved disability and QOL during 60 weeks of observation.

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“…Third, our study involved the use of PRPr [18] but not PRP itself. Therefore, it is possible that the efficacy might differ between PRPr and other variations of PRPs [16].…”

Section: Discussionmentioning

confidence: 99%

“…Clinical studies of intradiscal PRP injection treatment for patients with LBP have been reported [11] and a meta-analysis of 12 clinical studies showed significant improvements in LBP [16]. However, there has been only one RCT by Tuakli-Wosornu et al [17].…”

Section: Introductionmentioning

confidence: 99%

Platelet-Rich Plasma Releasate versus Corticosteroid for the Treatment of Discogenic Low Back Pain: A Double-Blind Randomized Controlled Trial

Akeda

Ohishi

Takegami

et al. 2022

JCM

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“…Thus far, 12 clinical studies that assessed the effects of intradiscal injection of PRP for patients with discogenic low back pain have been reported [ 30 ]. Among them, PRP itself was directly injected into degenerated discs in 11 studies, except for the one preliminary study of a PRPr injection [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…The effect of PRP on IVD degeneration has been investigated in vitro and in animal models, and it is reported that PRP has significant reparative effects to counteract IVD degeneration (see review in [ 29 ]). A recent meta-analysis of clinical trials of intradiscal PRP injections for patients with discogenic LBP showed a beneficial effect on pain relief outcome [ 30 ]; however, further studies are needed to confirm the clinical evidence of PRP therapy for the treatment of LBP.…”

Section: Introductionmentioning

confidence: 99%

Platelet-Rich Plasma-Releasate (PRPr) for the Treatment of Discogenic Low Back Pain Patients: Long-Term Follow-Up Survey

et al. 2022

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Background and Objectives: Clinical studies of platelet-rich plasma (PRP) for the treatment of low back pain (LBP) have been reported; however, less is known about its long-term efficiency. Materials and Methods: This study was a long-term follow-up of a previous prospective clinical feasibility study for the use of PRP releasate (PRPr) to treat discogenic LBP patients. Among 14 patients, 11 patients were evaluated for a long-term survey. The efficacy was assessed by a visual analogue scale (VAS) for LBP intensity and the Roland-Morris Disability Questionnaire (RDQ) for LBP-related disability. Radiographic disc height was evaluated for seven patients. Results: Improvements in VAS and RDQ were sustained at an average of 5.9 years after the intradiscal injection of PRPr (p < 0.01 vs. baseline, respectively). Clinically meaningful improvements (more than 30% decrease from baseline) in VAS and RDQ were identified in 91% of patients at final survey. The radiographic measurement of disc height of PRPr-injected discs showed a mild decrease (13.8% decrease compared to baseline) during the average 5.9 years. Conclusions: The results of this study with a small number of patients suggest that the intradiscal injection of PRPr has a safe and efficacious effect on LBP improvement for more than 5 years after treatment. Further large-scale studies would be needed to confirm the clinical evidence for the use of PRPr for the treatment of patients with discogenic LBP.

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“…Recently, several meta‐analyses demonstrated that intradiscal PRP injection had shown beneficial effects in controlling pain and improving disabilities in patients with LBP, but there was a paucity of high‐quality studies to give conclusive evidence 72,73 . Therefore, more clinical studies, especially RCTs with multiple outcome parameters, are necessary for evaluating the true efficacy of this treatment 74 . Moreover, according to the American Society of Interventional Pain Physicians guidelines, the qualitative evidence for intradiscal PRP injection in the treatment of LBP has been assessed as level III, based on the available evidence including RCT, observational studies, meta‐analysis, and systematic review 75…”

Section: Platelet‐rich Plasmamentioning

confidence: 99%

Intradiscal injection for the management of low back pain

Wang

et al. 2021

JOR Spine

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Low back pain (LBP) is a common clinical problem and a major cause of physical disability, imposing a prominent socioeconomic burden. Intervertebral disc degeneration (IDD) has been considered the main cause of LBP. The current treatments have limited efficacy because they cannot address the underlying degeneration. With an increased understanding of the complex pathological mechanism of IDD, various medications and biological reagents have been used for intradiscal injection for the treatment of LBP. There is increasing clinical evidence showing the benefits of these therapies on symptomatic relief and their potential for disc repair and regeneration by targeting the disrupted pathways underlying the cause of the disease. A brief overview of the potential and limitations for these therapies are provided in this review, based on the recent and available data from clinical trials and systematic reviews.Finally, future perspectives are discussed.intervertebral disc degeneration, intradiscal injection, low back pain | INTRODUCTIONLow back pain (LBP) is a common symptom that occurs below the costal margin and above the inferior gluteal fold, which refers to pain, muscle tension, or stiffness. The global prevalence of LBP in 2017 was 7.83%, and 577 million people were affected at any time. 1 In 2019, a systematic review of 13 studies from northern Europe, North America, and Israel reported that the prevalence of LBP ranged between 14% and 20%. 2 A systematic review and meta-analysis revealed that the lifetime prevalence of LBP was 47% in low-, lower-Fu Zhang and Songjuan Wang (shared first authorship) and Zhiyu Zhou and Shaoyu Liu (shared last authorship) contributed equally to this study.

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Does the Intradiscal Injection of Platelet Rich Plasma Have Any Beneficial Role in the Management of Lumbar Disc Disease?

Cited by 17 publications

References 53 publications

Platelet-Rich Plasma Releasate versus Corticosteroid for the Treatment of Discogenic Low Back Pain: A Double-Blind Randomized Controlled Trial

Platelet-Rich Plasma Releasate versus Corticosteroid for the Treatment of Discogenic Low Back Pain: A Double-Blind Randomized Controlled Trial

Platelet-Rich Plasma-Releasate (PRPr) for the Treatment of Discogenic Low Back Pain Patients: Long-Term Follow-Up Survey

Intradiscal injection for the management of low back pain

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