Charneux L, Demoulin C, Vanderthomment M, Tomasella M, Ferrara M-A, Grosdent S, Bethlen S, Fontaine R, Gillet P, Racaru T, Kaux J-F
Département des sciences de la motricité, université de Liège, allée des sports, B21, 4000 Liège, Belgique.
Département des sciences de la motricité, université de Liège, allée des sports, B21, 4000 Liège, Belgique; Service de medecine physique, réadaptation et traumatologie du sport, centre médical FIFA d'excellence, université de Liège, CHU de Liège, avenue de l'hôpital, B35, 4000 Liège, Belgique.
Neurochirurgie. 2017 Dec;63(6):473-477. doi: 10.1016/j.neuchi.2017.06.002. Epub 2017 Nov 8.
The spine has been the subject of extensive clinical research since it is the source of many painful complaints. However, there is little scientific evidence concerning the therapeutic proposals. During the course of life, the intervertebral disc degenerates, which over time diminishes its damping capacity and facilitates the expulsion of the nucleus pulposus through the annulus fibrosus. The degeneration of the intervertebral disc (DDI) is the origin of some back pain and various specific treatments have been developed. These include the infiltration at the center of the intervertebral disc of plasma rich platelet (PRP), composed of multiple growth factors which act on the disc degeneration. This treatment is recent and less invasive than surgery. Preliminary results seem promising. However, many gray areas and several parameters remained to be clarified. In an attempt to do this, a literature review was conducted based on bibliographic databases Pubmed, Medline and Scopus using the following Mesh terms : PRP, platelet-rich plasma, intradiscal disc degeneration, disc, intradiscal, discogenic. This analysis reveals that at the present time, no reported study has a sufficient perspective to judge the effectiveness of the infiltration of PRP. Early harvest results will be used to set the limits of this treatment. Accordingly, it is therefore currently recommended to introduce PRP injection as a complementary solution to comprehensive care of the spine. Future research will need to generate randomized controlled studies including comparing the results with conservative treatment and measure the cost-benefit relationship.
脊柱一直是广泛临床研究的主题，因为它是许多疼痛主诉的根源。然而，关于治疗方案的科学证据很少。在生命过程中，椎间盘会发生退变，随着时间的推移，其减震能力会下降，并促使髓核通过纤维环排出。椎间盘退变（DDI）是一些背痛的根源，并且已经开发了各种特定的治疗方法。这些方法包括在椎间盘中心注入富含血小板血浆（PRP），PRP由多种生长因子组成，可作用于椎间盘退变。这种治疗方法是最近才出现的，且比手术侵入性小。初步结果似乎很有前景。然而，仍有许多灰色地带和几个参数有待阐明。为了做到这一点，我们基于文献数据库Pubmed、Medline和Scopus，使用以下医学主题词进行了文献综述：PRP、富含血小板血浆、椎间盘内退变、椎间盘、椎间盘内、盘源性。该分析表明，目前尚无已报道的研究有足够的视角来判断PRP注射的有效性。早期收获的结果将用于确定这种治疗方法的局限性。因此，目前建议将PRP注射作为脊柱综合治疗的一种补充方案引入。未来的研究需要开展随机对照研究，包括将结果与保守治疗进行比较，并衡量成本效益关系。
