Department of Biology, Program in Liberal Medical Education (PLME), Brown University, Providence, RI, USA.
Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston, MA, USA.
Curr Pain Headache Rep. 2024 Nov;28(11):1079-1095. doi: 10.1007/s11916-024-01294-8. Epub 2024 Jul 17.
The purpose of this narrative review is to evaluate the efficacy of the most commonly studied intradiscal biologics used for the treatment and alleviation of chronic intractable discogenic low back pain. Additionally, it explores the therapeutic potential and durability of these novel treatment options. RECENT FINDINGS: Recently published literature highlights the therapeutic potential of intradiscal biologics, such as mesenchymal stem cells, platelet-rich plasma, and alpha-2-macroglobulin, in promoting chondrogenesis within the lumbar intervertebral discs to treat discogenic low back pain. Studies demonstrate significant improvements in pain relief, physical function, and quality of life post-treatment. A comprehensive review of the literature evaluating the efficacy of intradiscal biologics suggests some evidence supporting its efficacy in treating discogenic low back pain. However, more rigorous studies into mechanistic modulation and large-scale randomized trials as well as a more thorough understanding of adverse events will be instrumental for including these therapies into clinical practice paradigms.
本叙述性综述旨在评估最常用于治疗和缓解慢性难治性椎间盘源性下腰痛的椎间盘内生物制剂的疗效。此外,还探讨了这些新型治疗方法的治疗潜力和耐久性。
最近发表的文献强调了椎间盘内生物制剂(如间充质干细胞、富含血小板的血浆和α-2-巨球蛋白)在促进腰椎间盘内软骨生成以治疗椎间盘源性下腰痛方面的治疗潜力。研究表明,治疗后疼痛缓解、身体功能和生活质量有显著改善。对评估椎间盘内生物制剂疗效的文献进行全面回顾表明,有一些证据支持其治疗椎间盘源性下腰痛的疗效。然而,更深入的研究其机械调节作用以及更大规模的随机试验,以及更全面地了解不良反应,将有助于将这些疗法纳入临床实践模式。