Pitts John, Markle Jason, Berger Dustin, Dodson Ehren
Interventional Pain Management, Centeno-Schultz Clinic, Broomfield, USA.
Physical Medicine and Rehabilitation, Interventional Orthopedics and Regenerative Medicine, Centeno-Schultz Clinic, Broomfield, USA.
Cureus. 2025 May 15;17(5):e84166. doi: 10.7759/cureus.84166. eCollection 2025 May.
Cervical discogenic pain is a prevalent and debilitating condition. In recent years, autologous regenerative therapies such as bone marrow concentrate (BMC) and platelet-rich plasma (PRP) have gained attention as potential alternatives to traditional interventional pain management. This study investigates the safety and efficacy of these treatments when delivered intradiscally as part of a comprehensive cervical functional spinal unit (FSU) approach.
This is a retrospective case series utilizing registry data, with 18 participants meeting the inclusion criteria. Intradiscal injections of BMC or leukocyte-rich PRP were guided by ultrasound and fluoroscopy with contrast confirmation. Patient-reported outcome measures (PROMs), including the Functional Rating Index (FRI), Numeric Pain Scale (NPS), and a modified Single Assessment Numeric Evaluation (SANE), were collected at baseline and at a minimum of three months post-treatment, with a mean follow-up of one year.
Eleven participants received BMC injections, and seven received leukocyte-rich PRP injections. No adverse events were reported during the study period. Statistical analysis revealed a significant reduction in the NPS in half of the patients (9 of 18) (mean difference = -1.0, P = 0.024), while a majority (14 of 18) reported improvement in FRI scores (mean difference = -10.9, P = 0.015). The average SANE score was 60%, with most patients (14 of 18) reporting 50% or greater improvement.
Intradiscal injections of BMC or LR-PRP as part of a comprehensive cervical FSU approach appear to be safe and effective for improving patient-reported pain and function. These findings support the potential of autologous biologics as an alternative treatment modality for cervical discogenic pain.
颈椎间盘源性疼痛是一种常见且使人衰弱的病症。近年来，自体再生疗法如骨髓浓缩物（BMC）和富血小板血浆（PRP）作为传统介入性疼痛管理的潜在替代方法受到关注。本研究调查了这些治疗作为综合颈椎功能脊柱单元（FSU）方法的一部分进行椎间盘内注射时的安全性和有效性。
这是一项利用登记数据的回顾性病例系列研究，18名参与者符合纳入标准。在超声和荧光透视引导下并经造影剂确认后进行椎间盘内注射BMC或富含白细胞的PRP。在基线时以及治疗后至少三个月收集患者报告的结局指标（PROMs），包括功能评分指数（FRI）、数字疼痛量表（NPS）和改良的单项评估数字评价（SANE），平均随访一年。
11名参与者接受了BMC注射，7名接受了富含白细胞的PRP注射。研究期间未报告不良事件。统计分析显示，一半患者（18名中的9名）的NPS显著降低（平均差异=-1.0，P=0.024），而大多数患者（18名中的14名）报告FRI评分有所改善（平均差异=-10.9，P=0.015）。平均SANE评分为60%，大多数患者（18名中的14名）报告改善了50%或更多。
作为综合颈椎FSU方法的一部分进行椎间盘内注射BMC或LR-PRP似乎对改善患者报告的疼痛和功能是安全有效的。这些发现支持了自体生物制剂作为颈椎间盘源性疼痛替代治疗方式的潜力。
