A novel full endoscopic annular repair technique combined with autologous conditioned plasma intradiscal injection: a new safe serial therapeutic model for the treatment of lumbar disc herniation

Li, Jizheng; Yuan, Xiaofeng; Li, Fanbing; Wang, Fuke; Liu, Yanlin; Wang, Enbin; Yang, Xianguang; Xiang, Yaoyu; Song, En

doi:10.21037/apm-20-2257

Cited by 5 publications

(12 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ACP, a type of PRP, was also applied in an observational study by Jiang et al 26 Activated platelets release growth factors and downregulate several inflammatory factors that can promote the repair of different injuries. 22 In a three-arm study by Xu et al, 24 the second trial group received AFS and bone mesenchymal stem cells (BMSCs), which can effectively promote tissue repair. Figure 2 shows various annular repair techniques.…”

Section: Resultsmentioning

confidence: 99%

Annulus Fibrosus Repair for Lumbar Disc Herniation: A Meta-Analysis of Clinical Outcomes From Controlled Studies

Wang

Chen

et al. 2023

Global Spine Journal

View full text Add to dashboard Cite

Study Design Meta-analysis . Objectives This study aimed to summarize the clinical efficacy and safety of the various annular defect repair methods that have emerged in recent years. Methods A meta-analysis of randomized and non-randomized controlled trials was conducted. Articles from PubMed, Embase, and the Cochrane Library (CENTRAL) on Lumbar disc herniation treatment with annular repair published from inception to April 2, 2022 were included. We summarized the clinical efficacy and safety of annular repair techniques based on a random-effects model meta-analysis. Results 7 randomized controlled studies and 8 observational studies with a total of 2161 participants met the inclusion criteria. The pooled data analysis showed that adding the annular repair technique reduced postoperative recurrence rate, reoperation rate, and loss of intervertebral height compared with lumbar discectomy alone. Subgroup analysis based on different annular repair techniques showed that the Barricaid Annular Closure Device (ACD) was effective in preventing re-protrusion and reducing reoperation rates, while there was no significant difference between the other subgroups. The annulus fibrosus suture (AFS) did not improve the postoperative Oswestry Disability Index (ODI). No statistically significant difference was observed in the incidence of adverse events between the annular repair and control groups. Conclusions Lumbar discectomy combined with ACD can effectively reduce postoperative recurrence and reoperation rates in patients with LDH. AFS alone was less effective in reducing recurrence and reoperation rates and did not improve postoperative pain and function.

show abstract

Section: Resultsmentioning

confidence: 99%

Annulus Fibrosus Repair for Lumbar Disc Herniation: A Meta-Analysis of Clinical Outcomes From Controlled Studies

Wang

Chen

et al. 2023

Global Spine Journal

View full text Add to dashboard Cite

show abstract

“…Local inflammation factors, as one of the primary causes of pain, should not be ignored. To further improve the efficacy, PRP injection after discectomy can not only improve the clinical effectiveness but also repair the annular fibrosis [ 16 ]. The diverse factors released by PRP have positive effects on cell survival and proliferation, downregulation of proinflammatory cytokines, suppression of κ B pathways induced by tumor necrosis factor and interleukin-1 β , endogenous cannabinoid systems, subchondral bone homeostasis, and bone mineralization [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…The recurrence rate was significantly lower in the PRP group in our study, indicating that PRP can help prevent recurrence. Ideal remodeling of the AF can effectively set up a mechanical barrier to prevent further recurrence of disc herniation, reduce the occurrence of recompression and expand the area of the spinal canal [ 16 ], avoid postoperative intraspinal fibrotic scar formation, and minimize the release of inflammatory factors, thereby improving clinical efficacy and avoiding the occurrence of postoperative pain and numbness. After appropriate AF repair, the intervertebral disc may be seen as a closed space that prevents the leakage of various biological agents; this provides the basis for the biological treatment of intervertebral discs, and homeostasis of the intervertebral disc is the basis for avoiding recurrence [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…A recent systematic review and meta-analysis by Xuan et al [ 15 ] assessed PRP injection in the treatment of low back pain and showed an important ability to provide pain relief and patient satisfaction; PRP injection is recommended in the treatment of low back pain with caution due to puncture-related and drug-related complications. To our knowledge, only a few studies have evaluated the safety and effectiveness of TELD combined with PRP for patients with LDH [ 16 ] and the current evidence on the treatment of LDH with TELD and PRP is relatively low. The purpose of this study was to prospectively assess the efficacy and safety of PRP injection in patients after TELD and to identify whether PRP injection could provide better clinical efficacy, improve disc remodeling, and decrease the recurrence of LDH.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Transforaminal Endoscopic Lumbar Discectomy with versus without Platelet-Rich Plasma Injection for Lumbar Disc Herniation: A Prospective Cohort Study

Jiang

Zuo

Yuan

et al. 2022

Pain Research and Management

View full text Add to dashboard Cite

Objective. Transforaminal endoscopic lumbar discectomy (TELD) is an effective treatment for patients with lumbar disc herniation (LDH) with failure of conservative treatment. However, defects in the annulus fibrosus after TELD usually lead to a recurrence of LDH. Platelet-rich plasma (PRP) injection has shown promising potential for the repair of injured tissues. The combination of TELD and PRP injection has rarely been reported. Hence, this study aimed to evaluate the effectiveness, disc remodeling, and recurrence rate of LDH in TELD with or without PRP in LDH treatment. Methods. A total of 108 consecutive patients who underwent TELD were prospectively registered between July 2018 and December 2019 (https://clinicaltrials.gov/ct2/show/ChiCTR1800017228). Fifty-one and fifty-seven patients underwent TELD with PRP injections and TELD only, respectively. The visual analog scale (VAS) score for back and leg pain, Oswestry Disability Index (ODI), and MacNab criteria were evaluated, and perioperative complications were documented. The disc protrusion, spinal cross-sectional area (SCSA), and disc height were measured on MRI and evaluated preoperatively, postoperatively, and at regular follow-up. Results. All patients were followed up. Clinical improvement was noted in both groups. There were statistical differences in the VAS scores of back and leg pain and ODI between the two groups at 3 months, 6 months, and 1 year follow-up ( P < 0.05 ); the improvement in the PRP group was significant. The disc protrusion and SCSA on MRI in the PRP group showed better improvement, with lower recurrence rate, than that in the control group at the final follow-up ( P < 0.05 ). No adverse events were reported in our study following PRP injection. Conclusion. Our study showed that TELD with PRP injection was a safe and effective treatment for patients with LDH in the medium and long-term follow-up. PRP injection was beneficial for disc remodeling after endoscopic discectomy and decreased the recurrence of LDH.

show abstract

“…Several prosthesis/techniques have been developed for annular repair to minimize the morbidity of re-herniation till now, including annular closure device (ACD) -Barricaid ™ (Intrinsic Therapeutics, Inc., Woburn, MA, USA) technique, Anulex-Xclose (Anulex Technologies, Minnetonka, MN) technique, sutures and PushLock technique (10)(11)(12)(13), and "jetting suture" technique (14). However, controversy result continues about the outcomes during follow-up (10,12,(15)(16)(17)(18)(19). The present study aims to figure out whether the annular repair technique is useful for reducing recurrent LDH after limited discectomy.…”

Section: Introductionmentioning

confidence: 99%

Is annular repair technique useful for reducing reherniation and reoperation after limited discectomy?

Zhang¹,

Tang²,

Jiang³

et al. 2022

Acta Orthop Belg

View full text Add to dashboard Cite

The annular defect because of the primary lumbar disc herniation (LDH) or surgical procedure is considered a primary reason for recurrent herniation and eventually reoperation. Efforts to close the defect with annular repair devices have been attempted several times, but the results were controversial. The present aims to detect whether the annular repair techniques were useful for reducing the re-herniation and re- operation rate. The Pubmed, Cochrane library, and Embase databases were searched to retrieve relevant studies published before January 1, 2021. Continuous variables were compared by calculating the standard difference of the means (SDM), whereas categorical dichotomous variables were assessed using relative risks (RRs). A random-effects model was used if the heterogeneity statistic was significant; otherwise, a fixed-effects model was used. A total of 10 researches were suitable for the meta-analysis, including four different repair techniques and 1907 participates. Compared with the control group, there was no statistical difference with the ODI, VAS-leg, and VAS-back scales for patients treated with the annular repair. However, using an annular repair device was associated with a significant reduction in the re- herniation (p=0.004) and re-operation (0.004) rates. There was no difference between the groups with perioperative complications. However, much more device-related long-term complications happened in the annual repair group (p=0.031) though it still decreased the overall re-operation rate significantly (p=0.006).Our results demonstrated that using an annular repair device was safe and beneficial for reducing re-herniation and re-operation rates.

show abstract

A novel full endoscopic annular repair technique combined with autologous conditioned plasma intradiscal injection: a new safe serial therapeutic model for the treatment of lumbar disc herniation

Cited by 5 publications

References 19 publications

Annulus Fibrosus Repair for Lumbar Disc Herniation: A Meta-Analysis of Clinical Outcomes From Controlled Studies

Annulus Fibrosus Repair for Lumbar Disc Herniation: A Meta-Analysis of Clinical Outcomes From Controlled Studies

Transforaminal Endoscopic Lumbar Discectomy with versus without Platelet-Rich Plasma Injection for Lumbar Disc Herniation: A Prospective Cohort Study

Is annular repair technique useful for reducing reherniation and reoperation after limited discectomy?

Contact Info

Product

Resources

About