自体富血小板血浆在莫迪奇 1 型腰痛患者中的椎间盘内给药:前瞻性试点研究

IF 3.4 3区 医学 Q1 ORTHOPEDICS
JOR Spine Pub Date : 2024-03-18 DOI:10.1002/jsp2.1320
Soya Kawabata, Sota Nagai, Kei Ito, Hiroki Takeda, Daiki Ikeda, Yusuke Kawano, Shinjiro Kaneko, Yukako Shiraishi, Yuichiro Sano, Yoshiharu Ohno, Nobuyuki Fujita
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引用次数: 0

摘要

背景 已经报道了多种治疗慢性腰背痛(LBP)的方法,其中作为再生医学的富血小板血浆(PRP)备受关注。虽然莫迪奇 1 型改变(MC1)与腰背痛有关,但迄今为止尚未确定治疗方法。此外,也没有任何研究仅针对 MC1 对椎间盘(IVD)注射 PRP。因此,本研究旨在确定对患有 MC1 的椎间盘突出症患者施用 PRP 的安全性和有效性。 方法 为 10 名腰痛的 MC1 患者在腹腔内注射 PRP。在初次给药后,对患者进行了长达 24 周的前瞻性随访。对患者的身体状况、实验室数据和腰椎 X 光图像进行评估,以进行安全性评估。此外,为了评估 PRP 的有效性,还考虑了患者报告的结果。此外,还使用磁共振成像(MRI)评估了 MC1 的变化。 结果 用药后,实验室数据和腰椎 X 光图像均未出现不良反应。治疗前的平均视觉模拟量表为(70.0 ± 13.3),注射 PRP 1 周后显著下降,最后一次观察时为(39.0 ± 28.8)。奥斯韦特里残疾指数和罗兰-莫里斯残疾问卷评分在治疗后迅速改善,在注射 PRP 24 周后均有明显改善。治疗 24 周后的磁共振成像随访显示,与使用 PRP 前相比,脂肪抑制 T2 加权成像的平均高信号强度从 10.1 mm2 显著降至 7.90 mm2。 结论 对腰椎间盘突出症 MC1 患者的 IVD 施用 PRP 具有安全性和有效性。治疗后的磁共振成像显示炎症有所改善,推测 PRP 抑制了炎症,从而缓解了患者的症状。尽管患者人数较少,但这种治疗方法对于患有枸杞多糖症的 MC1 患者来说前景广阔。该研究方案已通过再生医学认证委员会和日本厚生劳动省的审查和批准(日本临床试验登记[jRCT]编号:jRCTb042210159)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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

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

Background

Various treatments for chronic low back pain (LBP) have been reported; among them, platelet-rich plasma (PRP) as a regenerative medicine has attracted much attention. Although Modic type 1 change (MC1) is associated with LBP, no treatment has been established so far. In addition, no studies have administered PRP to intervertebral discs (IVDs) in patients with LBP, targeting MC1 only. Thus, the purpose of this study was to determine the safety and efficacy of PRP administration to the IVDs in patients with MC1 experiencing LBP.

Methods

PRP was injected intradiscally to 10 patients with MC1 experiencing LBP. Patients were followed prospectively for up to 24 weeks after primary administration. Physical condition, laboratory data, and lumbar x-ray images were evaluated for safety assessment. Furthermore, to evaluate the effectiveness of PRP, patient-reported outcomes were considered. In addition, changes in MC1 were assessed using magnetic resonance imaging (MRI).

Results

There were no adverse events in the laboratory data or lumbar X-ray images after administration. The mean visual analog scale, which was 70.0 ± 13.3 before the treatment, significantly decreased 1 week after PRP administration and was 39.0 ± 28.8 at the last observation. Oswestry disability index and Roland Morris disability questionnaire scores promptly improved after treatment, and both improved significantly 24 weeks after PRP administration. Follow-up MRI 24 weeks after treatment showed a significant decrease in the mean high-signal intensity of fat-suppressed T2-weighted imaging from 10.1 to 7.90 mm2 compared with that before PRP administration.

Conclusions

The safety and efficacy of PRP administration to the IVDs of patients with MC1 experiencing LBP were identified. Post-treatment MRI suggested improvement in inflammation, speculating that PRP suppressed inflammation and consequently relieved the patient's symptoms. Despite the small number of patients, this treatment is promising for patients with MC1 experiencing LBP. The study protocol has been reviewed and approved by the Certified Committee for Regenerative Medicine and the Japanese Ministry of Health, Labor and Welfare (Japan Registry of Clinical Trials [jRCT] No. jRCTb042210159).

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来源期刊
JOR Spine
JOR Spine ORTHOPEDICS-
CiteScore
6.40
自引率
18.90%
发文量
42
审稿时长
10 weeks
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