Steroid vs. Platelet‐Rich Plasma in Ultrasound‐Guided Sacroiliac Joint Injection for Chronic Low Back Pain

Singla, Varun; Batra, Yatindra Kumar; Bharti, Neerja; Goni, Vijay; Marwaha, Neelam

doi:10.1111/papr.12526

Cited by 73 publications

(53 citation statements)

References 19 publications

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“…Ultimately, three RCTs were included in the meta-analysis. 25,27,28 ►Table 1 summarizes the baseline characteristics of the three eligible RCTs in the meta-analysis. The three studies were published between 2016 and 2017, and sample sizes ranged from 40 to 46 with a total of 131.…”

Section: Literature Search Study Characteristics and Quality Assessmentioning

confidence: 99%

“…24 Previous studies demonstrated that PRP by periarticular injection, sacroiliac joint injection, or intradiskal injection results in significant improvement in pain scores for low back pain. 25,26 In contrast to this promising finding, however, some relevant randomized controlled trials (RCTs) showed that PRP injection had no influence on pain scores and patient satisfaction for low back pain. 27,28 Considering these inconsistent effects, we therefore conducted a systematic review and meta-analysis of RCTs to evaluate the effectiveness of PRP injection in patients with low back pain.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Platelet-rich Plasma for Low Back Pain: A Systematic Review and Meta-analysis

Zhang

Dou

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

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Background Platelet-rich plasma (PRP) may be beneficial for patients with low back pain. However, the results remain controversial. We conducted a systematic review and meta-analysis to explore the efficacy of PRP for low back pain. Methods PubMed, Embase, Web of Science, EBSCO, and Cochrane Library databases were searched systematically. Randomized controlled trials (RCTs) assessing the effect of PRP on low back pain were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was pain scores within 8 weeks. Meta-analysis was performed using the random-effects model. Results Three RCTs involving 131 patients were included in the meta-analysis. Overall, compared with control intervention for low back pain, PRP injection was found to reduce pain scores significantly (mean difference: − 1.47; 95% confidence interval [CI], − 2.12 to − 0.81; p < 0.0001), improve the number of patients with > 50% pain relief at 3 months (risk ratio [RR]: 4.14; 95% CI, 2.22–7.74; p < 0.00001), and offer relatively good patient satisfaction (RR: 1.91; 95% CI, 1.04–3.53; p = 0.04). No increase in adverse events was reported after PRP injection (RR: 1.92; 95% CI, 0.94-3.91; p = 0.07). Conclusions Compared with control intervention for low back pain, PRP injection was found to improve pain relief and patient satisfaction significantly with no increase in adverse events.

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Section: Literature Search Study Characteristics and Quality Assessmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of Platelet-rich Plasma for Low Back Pain: A Systematic Review and Meta-analysis

Zhang

Dou

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

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“…Patients in the PRP group maintained 90% efficacy at 3 months, while the steroid group maintained 25% efficacy. Modified ODI and SF‐12 scores gradually improved in the PRP group through 3 months, while the steroid group demonstrated initial improvement at 4 weeks with subsequent deterioration at 3 months . Additionally, there were two level IV studies that demonstrated significant pain reduction at 1 year, with one study demonstrating sustained clinical benefits through 4 years .…”

Section: Orthobiologics and The Literaturementioning

confidence: 99%

Regenerative Medicine for Axial and Radicular Spine‐Related Pain: A Narrative Review

et al. 2020

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Introduction Regenerative injection‐based therapy has established itself as a therapeutic option for the management of a variety of painful musculoskeletal conditions. The aim of this work was to review the current literature regarding regenerative injection therapy for axial/radicular spine pain. Methods A comprehensive literature review was conducted on the use of regenerative medicine for axial/radicular spine pain. Eligible articles analyzed the therapeutic injection effects of platelet‐rich plasma (PRP), prolotherapy, or mesenchymal signaling cells (MSCs) via intradiscal, facet joint, epidural, or sacroiliac joint delivery. Results Regarding intradiscal PRP, there are level I/IV studies supporting its use. Regarding intradiscal prolotherapy, there are level III to IV studies supporting its use. Regarding intradiscal MSCs, there are level I/IV studies supporting its use with the exception of one level IV study that found no significant improvement at 12 months. Regarding facet joint injections with PRP, there are level I/IV studies supporting its use. Regarding facet joint injections with prolotherapy, there are level IV studies supporting its use, though the one level I study did not demonstrate any statistical significance supporting its use. Regarding epidural injections with PRP, there are level I/IV studies supporting its use. Regarding epidural injections with prolotherapy, there are level IV studies supporting its use, though the one level I study did not demonstrate statistical significance beyond 48 hours. Regarding sacroiliac joint injections with PRP, there are level I/IV studies supporting its use. Regarding sacroiliac joint injections with prolotherapy, there are level I/III studies supporting its use. Conclusions Currently, there are level I studies to support the use of PRP and MSC injections for discogenic pain; facet joint injections with PRP; epidural injections of autologous conditioned serum and epidural prolotherapy; and PRP and prolotherapy for sacroiliac joint pain. One level I study showed that facet joint prolotherapy has no significant benefit. Notably, no intervention has multiple published level I studies.

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“…Пролотерапия (также известная как пролиферативная терапия) заключается в инъекции таких растворов, как декстроза и обогащенная тромбоцитами плазма, вокруг сухожилий или связок в попытке укрепления соединительной ткани и уменьшения скелетно-мышечной боли. Предполагаемый механизм -инициирование воспалительного процесса, который приводит к повышению кровотока и ускорению восстановления тканей [45]. В связи с возможностью развития микронестабильности КПС в последнее время активно обсуждается возможность операций с использованием стабилизирующих систем.…”

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Sacroiliac joint dysfunction: clinical presentations, diagnosis, treatment

Исайкин

Kavelina

Shor

et al. 2019

RJTAO

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One of the most common anatomical sources of nonspecific back pain is sacroiliac joint (SIJ) injury. The paper gives data on the structure, features of diagnosis and treatment of pain caused by SIJ dysfunction. A multimodal approach, including psychotherapeutic techniques, kinesiotherapy, the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and muscle relaxants, is recommended for chronic pain. The authors give their own experience with drug treatment of 51 patients (36 women and 15 men; mean age, 56.4±2.1 years) with SIJ dysfunction, by using periarticular blockages with local anesthetics and glucocorticoids or radiofrequency SIJ denervation. They note the efficiency of using Airtal® as a NSAID and Mydocalm® as a muscle relaxant.

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Steroid vs. Platelet‐Rich Plasma in Ultrasound‐Guided Sacroiliac Joint Injection for Chronic Low Back Pain

Abstract: The intra-articular PRP injection is an effective treatment modality in low back pain involving SIJ.

Cited by 73 publications

References 19 publications

Efficacy of Platelet-rich Plasma for Low Back Pain: A Systematic Review and Meta-analysis

Efficacy of Platelet-rich Plasma for Low Back Pain: A Systematic Review and Meta-analysis

Regenerative Medicine for Axial and Radicular Spine‐Related Pain: A Narrative Review

Sacroiliac joint dysfunction: clinical presentations, diagnosis, treatment

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