Gelalis Ioannis D, Christoforou Georgios, Charchanti Antonia, Gkiatas Ioannis, Pakos Emilios, Papadopoulos Dimitrios, Ploumis Avraam, Korompilias Anastasios
Deparment of Orthopaedic Surgery, School of Medicine, University of Ioannina, 45110, Ioannina, Greece.
Eur J Orthop Surg Traumatol. 2019 Apr;29(3):545-551. doi: 10.1007/s00590-018-2337-1. Epub 2018 Oct 28.
Platelet-rich plasma (PRP) treatment for intervertebral disc (IVD) repair and tissue engineering technologies have been the target of intense research with promising results. The purpose of this study was to investigate the effect of only one intradiscal injection of PRP in the degenerated rabbit IVD and to assess the restoration process over a 6-week follow-up period.
The L3-L4 and L4-L5 discs of 18 adult female rabbits were injured, according to an established degenerative model, with an 18-gauge needle, and classified into two groups: In the discs of group A rabbits, after needle puncture, an intradiscal injection of autologous PRP growth factors was performed, using a 27-gauge needle, and in the discs of the control group (group B), the same procedure was followed by intradiscal injection of normal saline. The PRP preparation was carried out aseptically, after blood collection from the same rabbit.
During the 6 weeks, there was a noteworthy progression of degeneration process in group B, whereas the grade of degeneration was significantly lower in group A, both for annulus fibrosus (AF) and for nucleus pulposus (NP). The intervertebral disc regeneration and reversal process of the lesions are obvious on 45 days after the injury, in group A. The hematoxylin and eosin histology grading score and the expression of collagen type II in NP and inner layer of AF were the markers better mirroring the degeneration and restoration process.
PRP intradiscal treatment in degenerative disc disease provokes the maintenance of the disc's basic morphological characteristics with restoration being evident early after injury.
富含血小板血浆（PRP）治疗椎间盘（IVD）修复及组织工程技术一直是深入研究的目标，且取得了有前景的结果。本研究的目的是调查在退变的兔IVD中仅进行一次椎间盘内注射PRP的效果，并评估在6周随访期内的修复过程。
根据已建立的退变模型，用18号针损伤18只成年雌性兔的L3-L4和L4-L5椎间盘，并分为两组：在A组兔的椎间盘内，针刺后用27号针进行自体PRP生长因子的椎间盘内注射，而在对照组（B组）的椎间盘内，同样操作后进行椎间盘内注射生理盐水。PRP制剂在从同一只兔采血后无菌制备。
在6周内，B组退变过程有显著进展，而A组的退变程度在纤维环（AF）和髓核（NP）方面均显著更低。在损伤后45天，A组的椎间盘再生和损伤逆转过程明显。苏木精和伊红组织学分级评分以及NP和AF内层中II型胶原的表达是更好反映退变和修复过程的标志物。
在退行性椎间盘疾病中进行PRP椎间盘内治疗可促使椎间盘基本形态特征得以维持，损伤后早期修复明显。
