Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Japan.
Department of Transfusion Medicine and Cell Therapy, Mie University Hospital, Tsu 514-8507, Japan.
Medicina (Kaunas). 2022 Mar 16;58(3):428. doi: 10.3390/medicina58030428.
Background and Objectives: Clinical studies of platelet-rich plasma (PRP) for the treatment of low back pain (LBP) have been reported; however, less is known about its long-term efficiency. Materials and Methods: This study was a long-term follow-up of a previous prospective clinical feasibility study for the use of PRP releasate (PRPr) to treat discogenic LBP patients. Among 14 patients, 11 patients were evaluated for a long-term survey. The efficacy was assessed by a visual analogue scale (VAS) for LBP intensity and the Roland-Morris Disability Questionnaire (RDQ) for LBP-related disability. Radiographic disc height was evaluated for seven patients. Results: Improvements in VAS and RDQ were sustained at an average of 5.9 years after the intradiscal injection of PRPr (p < 0.01 vs. baseline, respectively). Clinically meaningful improvements (more than 30% decrease from baseline) in VAS and RDQ were identified in 91% of patients at final survey. The radiographic measurement of disc height of PRPr-injected discs showed a mild decrease (13.8% decrease compared to baseline) during the average 5.9 years. Conclusions: The results of this study with a small number of patients suggest that the intradiscal injection of PRPr has a safe and efficacious effect on LBP improvement for more than 5 years after treatment. Further large-scale studies would be needed to confirm the clinical evidence for the use of PRPr for the treatment of patients with discogenic LBP.
已有临床研究报道富血小板血浆(PRP)治疗下腰痛(LBP)的疗效,但其长期疗效知之甚少。
本研究是先前 PRP 释放液(PRPr)治疗椎间盘源性 LBP 患者的前瞻性临床可行性研究的长期随访。在 14 名患者中,有 11 名患者进行了长期调查。采用视觉模拟评分(VAS)评估 LBP 强度,用 Roland-Morris 残疾问卷(RDQ)评估 LBP 相关残疾,对 7 名患者进行影像学椎间盘高度评估。
PRPr 椎间盘内注射后平均 5.9 年,VAS 和 RDQ 均持续改善(与基线相比,p < 0.01)。终期调查时,91%的患者 VAS 和 RDQ 有临床意义的改善(与基线相比下降超过 30%)。PRPr 注射椎间盘的影像学测量显示,在平均 5.9 年期间,椎间盘高度略有下降(与基线相比下降 13.8%)。
本研究纳入患者数量较少,结果表明 PRPr 椎间盘内注射治疗 LBP 可在治疗后 5 年以上安全有效改善 LBP。需要进一步的大规模研究来证实 PRPr 治疗椎间盘源性 LBP 患者的临床证据。