Muthu Sathish, Jeyaraman Madhan, Chellamuthu Girinivasan, Jeyaraman Naveen, Jain Rashmi, Khanna Manish
Indian Orthopaedic Rheumatology Association, Lucknow, Uttar Pradesh, India.
Indian Stem Cell Study Group, Lucknow, Uttar Pradesh, India.
Global Spine J. 2022 Apr;12(3):503-514. doi: 10.1177/2192568221998367. Epub 2021 Apr 12.
Systematic review and meta-analysis.
We performed this meta-analysis to evaluate whether intradiscal Platelet Rich Plasma(PRP) injection has any beneficial role in the management of lumbar disc disease.
We conducted independent and duplicate electronic database searches including PubMed, Embase, and Cochrane Library till September 2020 for studies investigating the role of intradiscal PRP in the management of lumbar disc disease. The analysis was performed in the R platform using OpenMeta[Analyst] software.
13 studies including 2 RCTs, 5 prospective, and 6 retrospective studies involving 319 patients were included in the meta-analysis. A single-arm meta-analysis of the included studies showed a beneficial effect of the intervention in terms of pain relief outcomes like VAS score (p < 0.001), pain component of SF-36 (p = 0.003) while such improvement was not seen in functional outcome measures like ODI score (p = 0.071), the physical component of SF-36 (p = 0.130) with significant heterogeneity noted among the included studies. No structural improvement in magnetic resonance imaging was observed (p = 0.106). No additional procedure-related adverse events were noted in the included studies (p = 0.662).
There is a paucity of high-quality studies to give conclusive evidence on the benefits of intradiscal PRP for lumbar disc disease. Although intradiscal PRP injection has shown some beneficial effect in controlling pain for lumbar disc disease, we could not find structural or functional improvement from the included studies. Hence, we recommend large double-blind double-arm randomized controlled studies to analyze the benefits of the intervention being analyzed.
系统评价与荟萃分析。
我们进行这项荟萃分析以评估椎间盘内注射富血小板血浆（PRP）在腰椎间盘疾病治疗中是否具有任何有益作用。
我们进行了独立且重复的电子数据库检索，包括截至2020年9月的PubMed、Embase和Cochrane图书馆，以查找研究椎间盘内PRP在腰椎间盘疾病治疗中作用的研究。使用OpenMeta[Analyst]软件在R平台上进行分析。
荟萃分析纳入了13项研究，包括2项随机对照试验、5项前瞻性研究和6项回顾性研究，涉及319例患者。对纳入研究的单臂荟萃分析显示，该干预措施在疼痛缓解结果方面具有有益效果，如视觉模拟评分（VAS）（p < 0.001）、SF-36疼痛分量表（p = 0.003），而在功能结局指标如Oswestry功能障碍指数（ODI）评分（p = 0.071）、SF-36身体分量表（p = 0.130）方面未观察到这种改善，纳入研究之间存在显著异质性。磁共振成像未观察到结构改善（p = 0.106）。纳入研究中未发现与额外手术相关的不良事件（p = 0.662）。
缺乏高质量研究来提供关于椎间盘内PRP治疗腰椎间盘疾病益处的确凿证据。尽管椎间盘内PRP注射在控制腰椎间盘疾病疼痛方面显示出一些有益效果，但我们在纳入研究中未发现结构或功能改善。因此，我们建议进行大型双盲双臂随机对照研究，以分析所研究干预措施的益处。
