The Role of Platelet Rich Plasma in the Management of Vertebrogenic and Discogenic Pain
Saurabh Kataria1, Utsav Patel4, Jeremiah Wijaya5, Kevin Yabut3, Muhammad Ayub3, Muhammad Khalid3, Tooba Aslam6, Alan Kaye2
1Neurology, 2Clinical and Interventional pain, Lousiana State University Health Sciences Center at Shreveport, 3Lousiana State University Health Sciences Center at Shreveport, 4Mayo Clinic at Jacksonville, 5Silaom Hospital Lippo Village, 6Central Park Medical College
Objective:
To elucidate the role of platelet-rich plasma in treating vertebrogenic and discogenic pain.
Background:
Lower back pain is a commonly encountered problem in the United States that can be attributed to a multitude of factors. Pathologies such as intervertebral disk(IVD) degeneration leading to discogenic pain, vertebral end plate damage leading to chronic vertebrogenic pain are two common causes of back pain. Platelet-rich plasma(PRP) is an emerging medical treatment that is high in autologous platelets, growth factors, cytokines, and chemokines.
Design/Methods:
The inclusion criterias were randomized controlled trials and observational studies that used PRP as therapy for vertebrogenic/discogenic back pain. The exclusion criterias included case reports, case series, animal studies, letters, editorials, conference abstracts, and other studies not related to vertebrogenic or discogenic pain. The outcome measured was ODI score and the impact of PRP therapy on their quality of life.
Results:
The use of PRP in vertebrogenic and discogenic pain has been the subject of several studies. In a preliminary clinical trial, Akeda et al.found out that intradiscal injection of autologous PRP releasate was safe and had started show efficacy in patients with discogenic low back pain.Similar results were found in the studies by Lutz et al. with higher-concentration PRP injections in patients with chronic discogenic pain. We encountered several limitations, including a relatively small sample size, a brief follow-up period, patient heterogeneity, and limited generalizability. Therefore, more studies should be conducted for the implementation of PRP for the management of low back pain.
Conclusions:
The available meta-analyses and systematic reviews indicate that individuals treated with PRP for chronic discogenic back pain had significant improvement in pain and function. However, the modest sample size of studies may curtail the ability to generalize findings effectively and attain statistical power. Further research is needed to be able to generalize PRP therapy to a broader patient population.