Smith Ashley, Andruski Ben, Deng George, Burnham Robert
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada 2500 University Drive, Calgary, Alberta, T2N 1N4, Canada.
VivoCura Health, Calgary, Alberta, Canada #100, 325 Manning Rd NE, Calgary, Alberta, T2E 2P5, Canada.
Interv Pain Med. 2022 Mar 9;1(2):100078. doi: 10.1016/j.inpm.2022.100078. eCollection 2022 Jun.
To explore the safety and feasibility of a single autologous injection of platelet-rich plasma (PRP) in cervical facet joints of people with chronic WAD and facet-mediated pain, and explore the association between pain relief reported with diagnostic medial branch blocks (MBBs) and 3-months post-PRP.
A prospective case series of people with chronic whiplash-associated disorders and cervical facet joint mediated pain in a community setting.
A single autologous PRP injection was provided to cervical facet joints under ultrasound and fluoroscopic guidance.
Adverse events were recorded one-week, and measures of pain (numerical pain rating scale - NPRS) and disability (Neck Disability Index - NDI) were collected prior to and 3-months following cervical facet joint PRP. People not reached for follow-up were considered failures for worst-case analysis. The correlation between percentage response to diagnostic cervical medial branch blocks (MBBs) and percentage pain relief reported at 3-months was also investigated.
Forty-four people (82% female; mean age (SD): 45.2 (10.8) years) underwent cervical facet joint PRP. There was a significant improvement in pain and disability following PRP. Seventy percent of people exceeded MCID for pain. For NDI scores, 80% of people exceeded MCID. Forty-one percent of people reported greater than 50% relief of pain 3-months post-cervical facet joint PRP.There was no significant correlation between percentage relief of pain with cervical MBBs and percentage relief of pain 3-months post-PRP ( = 0.06, = 0.73).There were no adverse events reported.
In people with chronic WAD and facet-mediated pain, preliminary data suggests that PRP is safe and it is feasible to move forwards with randomized studies to further investigate efficacy and effectiveness.
探讨单次自体注射富血小板血浆（PRP）用于慢性挥鞭样损伤相关疾病（WAD）和小关节介导性疼痛患者颈椎小关节的安全性和可行性，并探讨诊断性内侧支阻滞（MBB）报告的疼痛缓解与PRP注射后3个月之间的关联。
在社区环境中对慢性挥鞭样损伤相关疾病和颈椎小关节介导性疼痛患者进行的一项前瞻性病例系列研究。
在超声和荧光镜引导下向颈椎小关节单次注射自体PRP。
在注射PRP前及注射后3个月记录不良事件，并收集疼痛（数字疼痛评分量表 - NPRS）和功能障碍（颈部功能障碍指数 - NDI）的测量数据。未进行随访的患者在最坏情况分析中被视为失败。还研究了诊断性颈椎内侧支阻滞（MBB）的反应百分比与3个月时报告的疼痛缓解百分比之间的相关性。
44例患者（82%为女性；平均年龄（标准差）：45.2（10.8）岁）接受了颈椎小关节PRP注射。PRP注射后疼痛和功能障碍有显著改善。70%的患者疼痛超过最小临床重要差异（MCID）。对于NDI评分，80%的患者超过MCID。41%的患者报告在颈椎小关节PRP注射后3个月疼痛缓解超过50%。颈椎MBB的疼痛缓解百分比与PRP注射后3个月的疼痛缓解百分比之间无显著相关性（r = 0.06，p = 0.73）。未报告不良事件。
对于慢性WAD和小关节介导性疼痛患者，初步数据表明PRP是安全的，开展随机研究以进一步调查其疗效和有效性是可行的。
