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经椎间孔注射自体富血小板血浆治疗腰椎间盘突出症:越南一项单中心前瞻性研究

Transforaminal injection of autologous platelet-rich plasma for lumbar disc herniation: A single-center prospective study in Vietnam.

作者信息

Le Viet-Thang, Nguyen Dao Luan Trung, Nguyen Anh Minh

机构信息

Department of Neurosurgery, University Medical Center, Ho Chi Minh City, Vietnam; Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.

Department of Neurosurgery, University Medical Center, Ho Chi Minh City, Vietnam.

出版信息

Asian J Surg. 2023 Jan;46(1):438-443. doi: 10.1016/j.asjsur.2022.05.047. Epub 2022 May 28.

Abstract

OBJECTIVE

Lumbar radiculopathy is a major health problem, which often treated by neurosurgery or guided lumbar epidural steroids for pain relief. We used autologous Platelet Rich Plasma (PRP) as a novel pharmaceutical agent that has strongly emerged in recent years to treat patients of lumbar disc herniation. From that, we evaluated the efficacy of PRP via transforaminal route in treatment of radicular pain in patients with lumbar disc herniation.

METHODS

Twenty-five patients were enrolled and injected with 4 ml of autologous platelet rich plasma under fluoroscopic guidance via transforaminal epidural injection into area of affected nerve root. They were followed using Visual Analogue Scale (VAS), Modified Oswestry Disability Index (ODI) and Straight Leg Raising Test (SLRT) for clinical assessment.

RESULTS

Patients who received transforaminal injections with autologous PRP showed statistically significant improvements on all three evaluation tools (VAS, ODI, SLRT). The improvements were sustained over twelve-month follow-up and there were no associated complications.

CONCLUSION

Transforaminal injection with autologous PRP helps patients relieve chronic pains and be able return to work. Besides, autologous PRP can be considered as a good alternative to epidural steroids in management of lumbar disc herniation.

摘要

目的

腰椎神经根病是一个主要的健康问题,通常通过神经外科手术或在腰椎硬膜外注射类固醇来缓解疼痛。我们使用自体富血小板血浆(PRP)作为近年来新兴的一种新型药物制剂来治疗腰椎间盘突出症患者。据此,我们评估了经椎间孔途径注射PRP治疗腰椎间盘突出症患者神经根性疼痛的疗效。

方法

纳入25例患者,在透视引导下经椎间孔硬膜外注射4毫升自体富血小板血浆至受影响神经根区域。使用视觉模拟量表(VAS)、改良奥斯维斯特里功能障碍指数(ODI)和直腿抬高试验(SLRT)对他们进行随访以进行临床评估。

结果

接受经椎间孔注射自体PRP的患者在所有三项评估工具(VAS、ODI、SLRT)上均显示出统计学上的显著改善。这些改善在12个月的随访中持续存在,且无相关并发症。

结论

经椎间孔注射自体PRP有助于患者缓解慢性疼痛并能够重返工作岗位。此外,在腰椎间盘突出症的治疗中,自体PRP可被视为硬膜外类固醇的良好替代物。

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