Intradiscal platelet-rich plasma injections were safe for treatment of discogenic low back pain, according to recently published results.
“[We] really had not had any treatment for internally disrupted discs that cause chronic low back pain, and intradiscal [platelet-rich plasma] PRP is showing promise and it suggests that biologic therapies could help patients with internally disrupted disc disease,” Gregory E. Lutz, MD, physiatrist-in-chief emeritus at Hospital for Special Surgery and professor of Clinical Rehabilitation Medicine Weill Cornell Medical College Regenerative SportsCare Institute, told Healio.com/Orthopedics.
He added, “[This] was the first out-of-box therapy, meaning it was a basic PRP system, and there are many ways to optimize the injectate to either increase the concentration further of the platelets or use it with stem cells in the future. So, I think it is promising to show some improvements in patients.”
Gregory E. Lutz
Lutz and colleagues performed a literature review of PRP injectate. The review included animal studies, clinical trials and a clinical case.
Investigators cited a study performed by Tuakli-Wosornu and colleagues in which the researchers performed a double-blind, randomized, controlled trial of 47 patients with degenerative disc disease who underwent a single injection of PRP for discogenic low back pain and a control group of patients who were given contrast agent alone into symptomatic degenerative intervertebral discs.
In an analysis of 29 participants, investigators saw statistically significant improvements in pain, function and satisfaction in patients who received intradiscal PRP vs. the control group.
At 2 years after the injection, there were clinically significant improvements for Numeric Rating Scale worst pain, Functional Rating Index function, SF-36 pain and SF-36 function. After the PRP injection, investigators did not see any adverse events, such as disc-space infection, neurologic injury or progressive herniation.
Lutz and colleagues performed a clinical case study of a 54-year old woman with severe, chronic low back pain. She was given 1.5 mL of autologous PRP during discography and at 4 weeks postoperatively. Investigators found after 18 months postoperatively, the woman had sustained pain and functional improvements.
“[We] have a treatment for early-stage disc disease, which may change the natural history to a more favorable outcome,” he said. “I think intradiscal biologics are the future of spine care.” – by Monica Jaramillo
Disclosure: Lutz reports no relevant financial disclosures.