Kirchner Fernando, Anitua Eduardo
Barcelona Traumatology Institute, Mataró, Spain.
Eduardo Anitua Foundation for Biomedical Research, Vitoria, Spain; BTI-Biotechnology Institute, Vitoria, Spain.
J Craniovertebr Junction Spine. 2016 Oct-Dec;7(4):250-256. doi: 10.4103/0974-8237.193260.
Low back pain (LBP) is a complex and disabling condition, and its treatment becomes a challenge.
The aim of our study was to assess the clinical outcome of plasma rich in growth factors (PRGF-Endoret) infiltrations (one intradiscal, one intra-articular facet, and one transforaminal epidural injection) under fluoroscopic guidance-control in patients with chronic LBP. PRGF-Endoret which has been shown to be an efficient treatment to reduce joint pain.
The study was designed as an observational retrospective pilot study. Eighty-six patients with a history of chronic LBP and degenerative disease of the lumbar spine who met inclusion and exclusion criteria were recruited between December 2010 and January 2012.
One intradiscal, one intra-articular facet, and one transforaminal epidural injection of PRGF-Endoret under fluoroscopic guidance-control were carried out in 86 patients with chronic LBP in the operating theater setting.
Descriptive statistics were performed using absolute and relative frequency distributions for qualitative variables and mean values and standard deviations for quantitative variables. The nonparametric Friedman statistical test was used to determine the possible differences between baseline and different follow-up time points on pain reduction after treatment.
Pain assessment was determined using a visual analog scale (VAS) at the first visit before (baseline) and after the procedure at 1, 3, and 6 months. The pain reduction after the PRGF-Endoret injections showed a statistically significant drop from 8.4 ± 1.1 before the treatment to 4 ± 2.6, 1.7 ± 2.3, and 0.8 ± 1.7 at 1, 3, and 6 months after the treatment, respectively, with respect to all the time evaluations ( < 0.0001) except for the pain reduction between the 3 and 6 month whose signification was lower ( < 0.05). The analysis of the VAS over time showed that at the end point of the study (6 months), 91% of patients showed an excellent score, 8.1% showed a moderate improvement, and 1.2% were in the inefficient score.
Fluoroscopy-guided infiltrations of intervertebral discs and facet joints with PRGF in patients with chronic LBP resulted in significant pain reduction assessed by VAS.
腰痛（LBP）是一种复杂且使人致残的病症，其治疗颇具挑战。
我们研究的目的是评估在X线透视引导控制下，对慢性腰痛患者进行富含生长因子血浆（PRGF-Endoret）注射（一次椎间盘内注射、一次关节突关节内注射和一次经椎间孔硬膜外注射）的临床疗效。PRGF-Endoret已被证明是减轻关节疼痛的有效治疗方法。
本研究设计为一项观察性回顾性试点研究。在2010年12月至2012年1月期间，招募了86例有慢性腰痛病史且患有腰椎退行性疾病并符合纳入和排除标准的患者。
在手术室环境中，对86例慢性腰痛患者在X线透视引导控制下进行一次PRGF-Endoret的椎间盘内注射、一次关节突关节内注射和一次经椎间孔硬膜外注射。
描述性统计采用定性变量的绝对和相对频率分布以及定量变量的均值和标准差。使用非参数Friedman统计检验来确定治疗后疼痛减轻在基线与不同随访时间点之间的可能差异。
在首次就诊时（基线）以及治疗后1、3和6个月，使用视觉模拟量表（VAS）进行疼痛评估。PRGF-Endoret注射后疼痛减轻具有统计学意义，从治疗前的8.4±1.1分别降至治疗后1、3和6个月的4±2.6、1.7±2.3和0.8±1.7，除了3个月和6个月之间疼痛减轻的显著性较低（<0.05）外，所有时间点评估均具有统计学意义（<0.0001）。对VAS随时间的分析表明，在研究终点（6个月）时，91%的患者评分优秀，8.1%的患者有中度改善，1.2%的患者评分无效。
对于慢性腰痛患者，在X线透视引导下用PRGF对椎间盘和关节突关节进行注射可使VAS评估的疼痛显著减轻。
