Advances in Platelet-Rich Plasma Treatment for Spinal Diseases: A Systematic Review

Abstract

Spinal diseases are commonly associated with pain and neurological symptoms, which negatively impact patients’ quality of life. Platelet-rich plasma (PRP) is an autologous source of multiple growth factors and cytokines, with the potential to promote tissue regeneration. Recently, PRP has been widely used for the treatment of musculoskeletal diseases, including spinal diseases, in clinics. Given the increasing popularity of PRP therapy, this article examines the current literature for basic research and emerging clinical applications of this therapy for treating spinal diseases. First, we review in vitro and in vivo studies, evaluating the potential of PRP in repairing intervertebral disc degeneration, promoting bone union in spinal fusion surgeries, and aiding in neurological recovery from spinal cord injury. Second, we address the clinical applications of PRP in treating degenerative spinal disease, including its analgesic effect on low back pain and radicular pain, as well as accelerating bone union during spinal fusion surgery. Basic research demonstrates the promising regenerative potential of PRP, and clinical studies have reported on the safety and efficacy of PRP therapy for treating several spinal diseases. Nevertheless, further high-quality randomized controlled trials would be required to establish clinical evidence of PRP therapy.

Intradiscal administration of autologous platelet‐rich plasma in patients with Modic type 1 associated low back pain: A prospective pilot study

“…In recent years, several regenerative medicine‐based treatments for LBP have been proposed, including the injection of mesenchymal stem cells (MSCs) and PRP. According to a 2023 systematic review of PRP therapy, 26 the first clinical trial of intradiscal administration of PRP was conducted by Tuakli‐Wosornu in 2016, 21 and 13 trials have been reported to date. Two randomized controlled studies, five prospective cohort studies, three retrospective cohort studies, and three case reports have been published.…”

“…Other systematic reviews and meta‐analyses showed that both MSC and PRP may be effective in the management of discogenic LBP; however, the level of evidence varied, and no high‐quality randomized controlled trials have been conducted. 26 , 29 , 30 , 31 , 32 More powered high‐quality studies are needed to truly assess the long‐term safety and efficacy of regenerative medicine approaches in discogenic LBP.…”

Analysis of global research hotspots and trends in immune cells in intervertebral disc degeneration: A bibliometric study

“… 87 A systematic review has demonstrated the regenerative potential of PRP in previous basic studies and recent clinical studies have reported that PRP therapy is safe and effective in the treatment of many spinal conditions. 88 Its role is also related to the regulation of immune cells such as macrophages. 89 Researchers have increased regenerative capacity and anti-inflammatory effects through pluronics nanomicelles containing a mixture of PRP and simvastatin (SIM) in a hydrogel, which was found to promote disc healing and significantly reduce inflammatory responses.…”

A new combination of pulsed radiofrequency and platelet-rich plasma injections for management of grade I lumbosacral spondylolisthesis: A prospective study

“…Limited studies have explored the use of PRP in the lumbar epidural space. Nevertheless, due to its potential, safety pro le and encouraging results, PRP has been considered an alternative to steroids for pain relief in such patients 12,13 . Notably, there is currently no data on combining PRF and PRP to achieve enhanced e cacy compared to using PRF or PRP alone.…”