Platelet-rich plasma injections for lumbar discogenic pain: A preliminary assessment of structural and functional changes

Abstract

The goal of this case review is to evaluate functional and structural changes with the use of intradiscal PRP in patients with lumbar discogenic pain. The secondary outcomes include improvement in pain, medication use, hospitalization, and surgery. Low back pain affects a large portion of the population causing a major social and economic effect. Current interventional treatments remain inadequate and transient targeting the symptoms without addressing the underlying cause. Platelet-rich plasma (PRP) has been used clinically in various settings for its healing properties attributed to growth factors. A total of 6 patients with chronic discogenic low back and leg pain who tried and failed conservative treatments were administered a single injection of 2-mm autologous PRP into the nucleus pulposus after careful study of the disk anatomy via discography and computed tomography scan. The patients were followed up at 2, 4, 8, 12, 16, 20, and 24 weeks; postinjection and primary and secondary outcomes were recorded. Verbal pain scale score for pain of all patients decreased more than 50% and their function increased for the period of 6 months and beyond. Postprocedure magnetic resonance imaging documented positive structural changes in small percentage of patients. None of the patients presented to the hospital or received surgery after this treatment. Although our preliminary results have been promising, well-designed randomized controlled trials are warranted to understand the full breath of the efficacy, risks, and complications from the use of PRP in the disk.