Platelet-Rich Plasma Therapy for Chronic Low Back Pain with Neuropathic Component in a Pain Medicine Clinic in Mexico: Retrospective Study

Journal of Drug Delivery and Therapeutics Pub Date : 2024-04-15 DOI:10.22270/jddt.v14i4.6541

César Amescua-García, María del Rocío Guillén-Núñez, Alfredo Martínez-Alvarado, Fernando Izquierdo-Moncayo, Luis Rujana-Galaviz, Daniela Hernández-Rodríguez

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Abstract

Introduction: Low back pain is a common problem affecting millions worldwide. Even after surgical treatment some patients do not improve; others suffer from persistent radiculopathy. We define Complex Chronic Low Back Pain (CCLBP) as any low back pain that has lasted for at least three months and has at least two triggering pain mechanisms. Objective: To describe our experience with platelet-rich plasma (PRP) therapy in managing CCLBP with a neuropathic component Methods: Quantitative, retrospective analysis from 57 medical records of patients treated with PRP for CCLBP. We used IBM-SPSS 21 to obtain descriptive statistics, Chi-square, Student T and Odds-Ratio. Results: The mean age of our sample was 59.8 (±14.4) years, with 6.51 (±8.7) years of pain and a follow-up of 9 (±12.2) months. 33.3% had lumbar surgery, 29.8% had lumbar trauma, 31.6% used a walking aid, 56.7% had MODIC changes on MRI, and 42% of them received intraosseous-PRP technic. 84.2% reported severe pain (VAS 8-10). The results showed that 96.5% of patients experienced some improvement after PRP treatment. Additionally, 10.5% experienced pain suppression. No significant differences in age, lumbar trauma, lumbar surgery, diseases, or the use of walking aids between patients who benefited from PRP treatment and those who did not. VAS after treatment shows significance (p<0.01) with 5.36±2.6 points. Subjects with less than five years of radicular pain had an improvement greater than 3 points on VAS (OR 7.38, IC95% 1.72-31.7). Conclusion: Autologous platelet-rich plasma injections for chronic low back pain with a neuropathic component are an effective alternative to address CCLBP’s current challenge. New studies with greater statistical power are necessary to make a statement of efficacy, but with the data obtained, it seems a promising option. Keywords: Platelet-Rich Plasma, Low Back Pain, Radiculopathy, Intraosseous

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在墨西哥一家疼痛医学诊所开展的富血小板血浆疗法治疗伴有神经病理性成分的慢性腰背痛：回顾性研究

简介腰背痛是影响全球数百万人的常见问题。即使接受了手术治疗，一些患者的病情仍不见好转；另一些患者则患有顽固性根神经病。我们将复杂性慢性腰背痛（CCLBP）定义为持续至少三个月、至少有两种诱发疼痛机制的腰背痛。目的描述我们使用富血小板血浆（PRP）疗法治疗具有神经病理性成分的 CCLBP 的经验：对 57 名接受 PRP 治疗的 CCLBP 患者的病历进行定量、回顾性分析。我们使用 IBM-SPSS 21 获得描述性统计、卡方、学生 T 和比值比。结果：样本的平均年龄为 59.8 (±14.4)岁，疼痛年数为 6.51 (±8.7)年，随访时间为 9 (±12.2) 个月。33.3%的患者接受过腰部手术，29.8%的患者有腰部外伤，31.6%的患者使用助行器，56.7%的患者在磁共振成像中出现MODIC改变，42%的患者接受了骨内PRP技术。84.2%的患者报告有严重疼痛（VAS 8-10）。结果显示，96.5% 的患者在接受 PRP 治疗后病情有所改善。此外，10.5%的患者疼痛得到抑制。在年龄、腰部外伤、腰部手术、疾病或使用行走辅助工具方面，PRP 治疗获益患者与未获益患者之间无明显差异。治疗后的 VAS 值为 5.36±2.6 点，具有显著性（P<0.01）。根性疼痛少于五年的受试者在 VAS 上的改善超过 3 点（OR 7.38，IC95% 1.72-31.7）。结论自体富血小板血浆注射治疗具有神经病理性成分的慢性腰背痛是解决 CCLBP 当前难题的有效替代方案。有必要进行统计能力更强的新研究，以确定其疗效，但从已获得的数据来看，这似乎是一个很有前景的选择。关键词：富血小板血浆富血小板血浆、腰痛、根病、骨内治疗

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Journal of Drug Delivery and Therapeutics

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