Wu Jiuping, Zhou Jingjing, Liu Chibing, Zhang Jun, Xiong Wei, Lv Yang, Liu Rui, Wang Ruiqiang, Du Zhenwu, Zhang Guizhen, Liu Qinyi
Department of Orthopaedics, The Second Hospital, Jilin University, Changchun, Jilin, China.
Department of Imaging and Nuclear Medicine, The Second Hospital, Jilin University, Changchun, Jilin, China.
Pain Pract. 2017 Sep;17(7):914-924. doi: 10.1111/papr.12544. Epub 2017 Feb 22.
To compare the effectiveness and safety between autologous platelet-rich plasma (PRP) and Local Anesthetic (LA)/corticosteroid in intra-articular injection for the treatment of lumbar facet joint syndrome.
Forty-six eligible patients with lumbar facet joint syndrome were randomized into group A (intra-articular injection with PRP) and group B (intra-articular injection with LA/corticosteroid). The following contents were evaluated: pain visual analog scale (VAS) at rest and during flexion, and the Roland-Morris Disability Questionnaire (RMQ), Oswestry Disability Index (ODI), and modified MacNab criteria for pain relief and applications of post-treatment drugs. All outcome assessments were performed immediately after and at 1 week, 1, 2, 3, and 6 months after treatment.
No significant difference between groups was observed at baseline. Compared with pretreatment, both group A and group B demonstrated statistical improvements in the pain VAS score at rest or during flexion, the RMQ, and the ODI (P < 0.01). And there were significant differences between the 2 groups on the above-mentioned items (P < 0.05). For group B, subjective satisfaction based on the modified MacNab criteria and objective success rate were highest (80% and 85%) after 1 month, but only 50% and 20% after 6 months. However, for group A, they increased over time. In addition, there were no treatment-related complications in either group during follow-up.
Both autologous PRP and LA/corticosteroid for intra-articular injection are effective, easy, and safe enough in the treatment of lumbar facet joint syndrome. However, autologous PRP is a superior treatment option for longer duration efficacy.
比较自体富血小板血浆(PRP)与局部麻醉剂(LA)/皮质类固醇关节内注射治疗腰椎小关节综合征的有效性和安全性。
将46例符合条件的腰椎小关节综合征患者随机分为A组(关节内注射PRP)和B组(关节内注射LA/皮质类固醇)。评估以下内容:静息和屈曲时的疼痛视觉模拟量表(VAS)、罗兰-莫里斯残疾问卷(RMQ)、奥斯威斯利残疾指数(ODI)以及改良MacNab疼痛缓解标准和治疗后药物应用情况。所有结局评估均在治疗后即刻以及治疗后1周、1、2、3和6个月进行。
两组在基线时未观察到显著差异。与治疗前相比,A组和B组在静息或屈曲时的疼痛VAS评分、RMQ和ODI方面均有统计学改善(P < 0.01)。两组在上述项目上存在显著差异(P < 0.05)。对于B组,基于改良MacNab标准的主观满意度和客观成功率在1个月后最高(分别为80%和85%),但在6个月后仅为50%和20%。然而,对于A组,它们随时间增加。此外,随访期间两组均未出现与治疗相关的并发症。
自体PRP和LA/皮质类固醇关节内注射在治疗腰椎小关节综合征方面均有效、简便且安全。然而,自体PRP是一种疗效持续时间更长的更佳治疗选择。