Personalized Multitarget Biologic Injection in the Spine: Prospective Case Series of Multitarget Platelet-Rich Plasma for Low Back Pain

Machado, Edilson Silva; Ambach, Mary A; Caldas, José Mp; Wei, Jason J; Bredemeier, Markus

doi:10.2217/rme-2021-0019

Cited by 6 publications

(21 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The current understanding of the degenerative process in the spine and the interrelationship between the different structures of the spine suggests that the vast majority of patients with chronic low back pain do not have only one pain-generating site. In our first case series, 81.8% of the patients presented alterations in two or more sites, with facet arthrosis (91.3%) and disc degeneration (60.9%) being the most frequent [21]. Evaluation of the cause of chronic LBP is complex due to many different structures involved and the multifactorial nature of the disease process.…”

Section: Discussionmentioning

confidence: 91%

“…A study previously published by our group showed good results in a protocol for the management of lumbar degenerative disease with the use of PRP in multiple painful structures of the lumbar spine, presenting the Muti Target concept [21]. The acronym PerMuTIS (Personalized Multi Target Biologic Injection in the Spine) was created to describe a concept of concurrent treatment of multiple pain generators in patients with LBP.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Regenerative Interventional Approach to the Management of Degenerative Low Back Pain

Machado¹

2022

JRMBR

View full text Add to dashboard Cite

Objective: Low back pain has been strongly related to the degenerative process of the spine, especially the degeneration of the intervertebral disc and facet joints. The main procedures for the management of low back pain are no intended to slow down or reverse the degenerative process. Platelet Rich Plasma (PRP), an orthobiologic product, has been the subject of several studies in the management of low back pain. Methods: A prospective case series study presenting the clinical results of 23 patients treated with PRP injections performed following clinical a interventionist protocol called PerMuTIS – Personalized Multi Target Biologic Injection of the Spine. The method to obtain the platelet concentrate was the Simple Double Spin technique, a low-cost double spin that produces Leucocyte Rich PRP. Baseline scores of pain and disability using the Visual Analog Scale (VAS) and Roland-Morris Disability Questionnaire (RMDQ) were recorded. Results: Mean VAS pain score across the cohort decreased by approximately 62%, while the Roland-Morris disability score decreased by about 60% at 52 weeks. There was no report of adverse events. The Leucocite and Monocite Rich PRP product showed concentration of 4.3X above baseline, with monocites concentration of 3.2X baseline. Conclusion: The concept of application in multiple targets using a simple and low-cost preparation technique proved to be feasible and without reports of serious side effects that compromise its indication. The PerMuTIS – Personalized Multi Target Biologic Injection in the Spine Technique using Simple Double Spin protocol demonstrated safety and feasibility in this prospective study of patients with low back pain who failed conservative treatments. Large scale, multicenter randomized clinical trial will provide an appropriate level of evidence to assist in clinical practice.

show abstract

Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

A Regenerative Interventional Approach to the Management of Degenerative Low Back Pain

Machado¹

2022

JRMBR

View full text Add to dashboard Cite

show abstract

“…The remainder of patients received ESIs. A total of six studies with 218 patients received epidural PRP [ 4 , 21 , 22 , 23 , 24 , 26 ]. Lemper et al used PRP diluted in platelet-poor plasma (PPP) in one patient [ 17 ].…”

Section: Resultsmentioning

confidence: 99%

“…One study included a subject with cervical and lumbar radiculopathy [ 17 ] and another two studies [ 20 , 25 ] enrolled subjects with either cervical or lumbar radiculopathy. The remaining studies included only lumbar radiculopathy [ 3 , 4 , 6 , 18 , 21 , 22 , 23 , 24 , 26 ].…”

Section: Resultsmentioning

confidence: 99%

“…Some studies described in detail the sequence and methods of PRP or platelet-derived product [ 6 , 18 , 19 , 21 , 22 , 23 , 25 ], and one study referred to their previous published protocols on PRP preparation [ 26 ] while others did not provide any details [ 4 , 17 , 20 ]. In the studies using PRGF, products were activated with calcium chloride following centrifugation and before application [ 19 , 25 ].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Platelet Rich Plasma and Platelet-Related Products in the Treatment of Radiculopathy—A Systematic Review of the Literature

et al. 2022

View full text Add to dashboard Cite

Back pain with radicular symptoms is associated with detrimental physical and emotional functioning and economic burden. Conservative treatments including physical, pharmacologic and injection therapy may not provide clinically significant or long-standing relief. Regenerative medicine research including Platelet rich plasma (PRP), Platelet lysate (PL) or Plasma rich in growth factors (PRGF) continues to develop, however evidence appraisal for treatment of radicular pain remains lacking. Thus, we performed a systematic review to evaluate the effectiveness of epidural steroid injections containing PRP or related products to treat radicular pain. Embase, PubMed/MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar databases were queried. Twelve studies were included in qualitative analysis, consisting of three randomized controlled trials and nine observational studies. The primary outcome was pain intensity, and secondary outcomes included functional improvement, anatomical changes on advanced imaging, and adverse events. All studies identified improved pain intensity and functional outcomes after epidural injection of PRP, PRGF and/or PL. Similar or longer lasting pain relief was noted in the PRP cohort compared to the cohort receiving epidural steroid injections with effects lasting up to 12–24 months. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) analysis revealed a very-low certainty of evidence due to risk of bias, indirectness, and imprecision.

show abstract

A comprehensive review of cell transplantation and platelet‐rich plasma therapy for the treatment of disc degeneration‐related back and neck pain: A systematic evidence‐based analysis

Schol,

Tamagawa,

Volleman

et al. 2024

JOR Spine

View full text Add to dashboard Cite

Low back pain (LBP) and neck pain predominate as the primary causes of disability. Cell‐ and platelet‐rich plasma (PRP) products are potential therapies with clinical trials and reviews promoting their efficacy. Nonetheless, they frequently disregard the clinical significance of reported improvements. In this systematic review, the effectuated improvements in pain, disability, quality of life (QoL), and radiographic images are comprehensively described and scored on their clinical significance. An electronic database literature search was conducted on July 2023 for in‐human assessment of cell or PRP products to alleviate discogenic pain. Papers were screened on quantitative pain, disability, QoL, radiographic improvements, and safety outcomes. Risk of bias was assessed through MINORS and Cochrane Source of Bias tools. Reported outcomes were obtained, calculated, and assessed to meet minimal clinically important difference (MCID) standards. From 7623 screened papers, a total of 80 articles met the eligibility criteria, presenting 68 specific studies. These presented at least 1974 treated patients. Overall, cell/PRP injections could alleviate pain and disability, resulting in MCID for pain and disability in up to a 2‐year follow‐up, similar to those observed in patients undergoing spinal fusion. Included trials predominantly presented high levels of bias, involved heterogeneous study designs, and only a minimal number of randomized controlled trials. Nonetheless, a clear clinically significant impact was observed for cell‐ and PRP‐treated cohorts with overall good safety profiles. These results highlight a strong therapeutic potential but also underline the need for future cost‐effectiveness assessments to determine the benefits of cell/PRP treatments.

show abstract

Personalized Multitarget Biologic Injection in the Spine: Prospective Case Series of Multitarget Platelet-Rich Plasma for Low Back Pain

Cited by 6 publications

References 48 publications

A Regenerative Interventional Approach to the Management of Degenerative Low Back Pain

A Regenerative Interventional Approach to the Management of Degenerative Low Back Pain

Platelet Rich Plasma and Platelet-Related Products in the Treatment of Radiculopathy—A Systematic Review of the Literature

A comprehensive review of cell transplantation and platelet‐rich plasma therapy for the treatment of disc degeneration‐related back and neck pain: A systematic evidence‐based analysis

Contact Info

Product

Resources

About