Efficacy of Platelet-rich Plasma for Low Back Pain: A Systematic Review and Meta-analysis

Abstract

Background Platelet-rich plasma (PRP) may be beneficial for patients with low back pain. However, the results remain controversial. We conducted a systematic review and meta-analysis to explore the efficacy of PRP for low back pain. Methods PubMed, Embase, Web of Science, EBSCO, and Cochrane Library databases were searched systematically. Randomized controlled trials (RCTs) assessing the effect of PRP on low back pain were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was pain scores within 8 weeks. Meta-analysis was performed using the random-effects model. Results Three RCTs involving 131 patients were included in the meta-analysis. Overall, compared with control intervention for low back pain, PRP injection was found to reduce pain scores significantly (mean difference: − 1.47; 95% confidence interval [CI], − 2.12 to − 0.81; p < 0.0001), improve the number of patients with > 50% pain relief at 3 months (risk ratio [RR]: 4.14; 95% CI, 2.22–7.74; p < 0.00001), and offer relatively good patient satisfaction (RR: 1.91; 95% CI, 1.04–3.53; p = 0.04). No increase in adverse events was reported after PRP injection (RR: 1.92; 95% CI, 0.94-3.91; p = 0.07). Conclusions Compared with control intervention for low back pain, PRP injection was found to improve pain relief and patient satisfaction significantly with no increase in adverse events.

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

“…According to MCMS, two studies were rated as good (scores between 70 and 84) and three studies were rated as fair (scores between 55 and 69) [21]. The overall SORT score was A and the GRADE score was B [21][22]. According to RoB2 and ROBINS-I, the overall risk of bias was low for three studies and moderate for two studies (Table 1).…”

“…To our knowledge, this is the first systematic review in the current literature assessing clinical outcomes between PRP and corticosteroid injections for the treatment of lumbar spondylosis and sacroiliac arthropathy. Although prior systematic reviews and meta-analyses have measured the potency of PRP for pain treatment in lumbar spondylosis and sacroiliac arthropathy, the majority of articles included in these studies were non-comparative in nature [22][23][24]41]. In the most recent meta-analysis by Xuan et al, prospective randomized controlled studies comparing PRP to other agents (including steroids) were analyzed.…”

“…PRP is believed to stimulate regeneration through the release of growth factors and proteins that may be involved in repairing the matrices of degenerative discs [21]. There are a few systematic reviews and meta-analyses in the literature assessing the efficacy of PRP for treatment in lumbar spondylosis and sacroiliac arthropathy [22][23]. However, these studies are limited, as they lack highquality randomized controlled trials (RCTs) or the analysis is non-comparative in nature.…”

“…However, these studies are limited, as they lack highquality randomized controlled trials (RCTs) or the analysis is non-comparative in nature. The most recent systematic review by Xuan et al assessed prospective randomized controlled trials comparing PRP to control treatments, but this study was limited in that it reviewed only three RCTs in the analysis [22]. Another recent review by Burnham et al also assessed PRP for sacroiliac arthropathy, utilizing three RCTs in their review, however, they were also limited by the number of available studies [24].…”

Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

“…The term orthobiologics has recently been introduced for the treatment of musculoskeletal (MSK) disorders, with promising results for the regenerative capacity of the heterogeneous biological active PRP cellular cocktail. Currently, PRP therapies are suitable treatment options with clinical benefits, with encouraging patient outcomes reported [ 2 , 3 , 4 ]. However, inconsistencies in patient outcomes and new insights have challenged the practicality of PRP clinical applications [ 5 , 6 , 7 ].…”