Huang Huagui, Wang Jinzuo, Liu Xin, Zhang Jing, Sun Tianze, Li Zhonghai
Department of Orthopedics, the First Affiliated Hospital of Dalian Medical University, Dalian Liaoning, 116011, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Mar 15;37(3):377-382. doi: 10.7507/1002-1892.202211047.
To summarize the research progress of platelet-rich plasma (PRP) for the treatment of discogenic low back pain (DLBP).
The literature on the treatment of DLBP with PRP was extensively reviewed, and the classification, treatment mechanism, and experiments and clinical trial progress of PRP were summarized.
According to the PRP composition, preparation methods, and physicochemical properties, there are five commonly used PRP classification systems at present. PRP is involved in delaying or reversing the progress of disc degeneration and pain control by promoting the regeneration of nucleus pulposus cells, increasing the synthesis of extracellular matrix, and regulating the internal microenvironment of degenerative intervertebral disc. Although several and studies have confirmed that PRP can promote disc regeneration and repair, significantly relieve pain, and even improve the mobility of DLBP patients. But the contrary conclusion has been reached in a few studies, and there are limitations to the application of PRP.
Current studies have confirmed the effectiveness and safety of PRP in the treatment of DLBP and intervertebral disc degeneration, as well as the advantages of PRP in terms of ease of extraction and preparation, low immunological rejection, high regenerative and repair capacity, and the ability to compensate for the shortcomings of traditional treatment modalities. However, relevant studies are still needed to further optimize PRP preparation methods, unify systematic classification guidelines, and clarify its long-term effectiveness.
总结富血小板血浆(PRP)治疗椎间盘源性下腰痛(DLBP)的研究进展。
广泛查阅有关PRP治疗DLBP的文献,总结PRP的分类、治疗机制以及实验和临床试验进展。
根据PRP的成分、制备方法和理化性质,目前有五种常用的PRP分类系统。PRP通过促进髓核细胞再生、增加细胞外基质合成以及调节退变椎间盘的内部微环境,参与延缓或逆转椎间盘退变进程并控制疼痛。尽管多项研究已证实PRP可促进椎间盘再生与修复、显著缓解疼痛,甚至改善DLBP患者的活动度。但也有少数研究得出了相反结论,且PRP的应用存在局限性。
目前的研究已证实PRP治疗DLBP和椎间盘退变的有效性与安全性,以及PRP在易于提取和制备、低免疫排斥反应、高再生和修复能力以及弥补传统治疗方式不足等方面的优势。然而,仍需要相关研究进一步优化PRP制备方法、统一系统分类指南并阐明其长期疗效。