Regenerative Sportscare Institute, New York, NY 10128, USA.
Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Regen Med. 2019 Sep;14(9):823-829. doi: 10.2217/rme-2019-0008. Epub 2019 Aug 19.
A 40-year-old woman with a history of chronic low back pain underwent a fluoroscopically guided intradiscal platelet-rich plasma injection (PRP) at the L5-S1 level. She subsequently developed progressive low back pain, night sweats and decreased ability to ambulate. Laboratory work-up revealed elevated acute phase reactants and imaging revealed L5-S1 intervertebral disc and vertebral end-plate abnormalities highly suggestive of spondylodiscitis. Computed tomography-guided aspiration and biopsy cultures grew and the patient was subsequently treated with intravenous antibiotics without surgical management. To the best of our knowledge, this is the first published case of lumbar spondylodiscitis following an intradiscal PRP injection, and brings to the forefront several clinically relevant issues including the antimicrobial effects of PRP, the role of in spine infections and the ideal treatment protocol for intradiscal biologics in order to minimize morbidity and optimize functional outcomes.
一位 40 岁的女性，有慢性下腰痛病史，在 L5-S1 水平接受了荧光镜引导下的椎间盘内富血小板血浆注射（PRP）。随后，她出现进行性下腰痛、夜间盗汗和行走能力下降。实验室检查发现急性期反应物升高，影像学显示 L5-S1 椎间盘和椎体终板异常，高度提示为脊椎炎。CT 引导下抽吸和活检培养出，随后给予静脉抗生素治疗，未行手术治疗。据我们所知，这是首例椎间盘内 PRP 注射后发生腰椎脊椎炎的病例，提出了几个临床相关问题，包括 PRP 的抗菌作用、在脊柱感染中的作用以及椎间盘内生物制剂的理想治疗方案，以尽量减少发病率并优化功能结果。
