Lumbar Intradiskal Platelet‐Rich Plasma (PRP) Injections: A Prospective, Double‐Blind, Randomized Controlled Study

Tuakli‐Wosornu, Yetsa A.; Terry, Alon; Boachie‐Adjei, Kwadwo; Harrison, Julian R.; Gribbin, Caitlin; LaSalle, Elizabeth E.; Nguyen, Joseph; Solomon, Jennifer L.; Lutz, Gregory E.

doi:10.1016/j.pmrj.2015.08.010

Cited by 212 publications

(187 citation statements)

References 34 publications

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“…PRP has been utilized in a variety of musculoskeletal indications with evidence of anti-inflammatory and healing properties. One study demonstrated that intradiscal injections of PRP led to symptomatic clinical benefit in individuals with chronic discogenic lower back pain [14]. By combining PRP with SVF, there may be an increased number of growth factors anad proteins which could translate to improved patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

Effects of the intradiscal implantation of stromal vascular fraction plus platelet rich plasma in patients with degenerative disc disease

Comella

Silbert²,

Parlo

2017

J Transl Med

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BackgroundStromal vascular fraction (SVF) can easily be obtained from a mini-lipoaspirate procedure of fat tissue and platelet rich plasma (PRP) can be obtained from peripheral blood. The SVF contains a mixture of cells including ADSCs and growth factors and has been depleted of the adipocyte (fat cell) population. We evaluated the safety and efficacy of administering SVF and PRP intra-discally into patients with degenerative disc disease.MethodsA total of 15 patients underwent a local tumescent liposuction procedure to remove approximately 60 ml of fat tissue. The fat was separated to isolate the SVF and the cells were delivered into the disc nucleus of patients with degenerative disc disease. The subjects were then monitored for adverse events, range of motion, visual analog scale (VAS), present pain intensity (PPI), Oswestry Disability Index (ODI), Beck Depression Inventory (BDI), Dallas Pain Questionnaire and Short Form (SF)-12 scores over a period of 6 months. Safety events were followed for 12 months.ResultsNo severe adverse events (SAEs) were reported during a 12 month follow up period with no incidences of infection. Patients demonstrated statistically significant improvements in several parameters including flexion, pain ratings, VAS, PPI, and short form questionnaires. In addition, both ODI and BDI data was trending positive and a majority of patients reported improvements in their Dallas Pain Questionnaire scores.ConclusionsOverall, patients were pleased with the treatment results. More importantly, the procedure demonstrated a strong safety profile with no severe adverse events or complications linked to the therapy. Trial registration NCT02097862. Name of registry: www.clinicaltrials.gov. https://clinicaltrials.gov/ct2/show/NCT02097862?term=bioheart&rank=6. Date of registration: March 25, 2014; Date of enrollment: March 2014

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Section: Introductionmentioning

confidence: 99%

Effects of the intradiscal implantation of stromal vascular fraction plus platelet rich plasma in patients with degenerative disc disease

Comella

Silbert²,

Parlo

2017

J Transl Med

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“…A prospective, double-blinded, randomized, placebo controlled study of 47 patients showed significant improvement outcomes in the intradiscal injected PRP group with regard to pain. Function (functional rating index) ( p =0.03) and outcome satisfaction (North American Spine Society) ( p =0.01) were revealed at 8-week follow-up and statistically improved function at the 1-year follow-up 79. Both of these studies conclude with a recommendation for additional trials of intradiscal PRP.…”

Section: Introductionmentioning

confidence: 64%

Treatment of chronic low back pain – new approaches on the horizon

Knežević¹,

Mandalia²,

Raasch³

et al. 2017

JPR

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Back pain is the second leading cause of disability among American adults and is currently treated either with conservative therapy or interventional pain procedures. However, the question that remains is whether we, as physicians, have adequate therapeutic options to offer to the patients who suffer from chronic low back pain but fail both conservative therapy and interventional pain procedures before they consider surgical options such as discectomy, disc arthroplasty, or spinal fusion. The purpose of this article is to review the potential novel therapies that are on the horizon for the treatment of chronic low back pain. We discuss medications that are currently in use through different phases of clinical trials (I–III) for the treatment of low back pain. In this review, we discuss revisiting the concept of chemonucleolysis using chymopapain, as the first drug in an intradiscal injection to reduce herniated disc size, and newer intradiscal therapies, including collagenase, chondroitinase, matrix metalloproteinases, and ethanol gel. We also review an intravenous glial cell-derived neurotrophic growth factor called artemin, which may repair sensory nerves compressed by herniated discs. Another new drug in development for low back pain without radiculopathy is a subcutaneous monoclonal antibody acting as nerve growth factor called tanezumab. Finally, we discuss how platelet-rich plasma and stem cells are being studied for the treatment of low back pain. We believe that with these new therapeutic options, we can bridge the current gap between conservative/interventional procedures and surgeries in patients with chronic back pain.

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“…Several studies have demonstrated improvement in clinical scores including ODI, VAS, and JOA beginning 1 month post-PRP injection [64][65][66][67]. Additionally, these studies have reported no complications associated with MSC and PRP injections [64].…”

Section: Treatment Non-operativementioning

confidence: 95%

Lumbar Disc Herniation

Amin

Andrade

Neuman³

2017

Curr Rev Musculoskelet Med

229

202

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Purpose of Review Substantial advancements have been made in the cause, diagnosis, imaging, and treatment options available for patients with lumbar disc herniation (LDH). We examined the current evidence and highlight the concepts on the frontline of discovery in LDH. Recent Findings There are a myriad of novel etiologies of LDH detailed in recent literature including inflammatory factors and infectious microbes. In the clinical setting, recent data focuses on improvements in computer tomography as a diagnostic tool and non-traditional injection options including tumor necrosis alpha inhibitors and platelet-rich plasma. Operative treatment outcomes have focused on minimally invasive endoscopic approaches and demonstrated robust 5-year post-operative outcomes. Summary Advances in the molecular etiology of LDH will continue to drive novel treatment options. The role of endoscopic treatment for LDH will continue to evolve. Further research into10-year outcomes will be necessary as this surgical approach continues to gain widespread popularity.

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Lumbar Intradiskal Platelet‐Rich Plasma (PRP) Injections: A Prospective, Double‐Blind, Randomized Controlled Study

Cited by 212 publications

References 34 publications

Effects of the intradiscal implantation of stromal vascular fraction plus platelet rich plasma in patients with degenerative disc disease

Effects of the intradiscal implantation of stromal vascular fraction plus platelet rich plasma in patients with degenerative disc disease

Treatment of chronic low back pain – new approaches on the horizon

Lumbar Disc Herniation

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Lumbar Intradiskal Platelet‐Rich Plasma (PRP) Injections: A Prospective, Double‐Blind, Randomized Controlled Study

Cited by 212 publications

References 34 publications

Effects of the intradiscal implantation of stromal vascular fraction plus platelet rich plasma in patients with degenerative disc disease

Effects of the intradiscal implantation of stromal vascular fraction plus platelet rich plasma in patients with degenerative disc disease

Treatment of chronic low back pain &ndash;&nbsp;new approaches on the horizon

Lumbar Disc Herniation

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Treatment of chronic low back pain – new approaches on the horizon