Smith Ashley D, Andruski Benjamin, Deng George, Bouma Colin, Pesant Marc, Magill Fiona, Burnham Robert
Department of Clinical Neurosciences, Cumming School of Medicine, Calgary, AB T2N 1N4, Canada.
Vivo Cura Health, Calgary, AB T2E 2P5, Canada.
Clin Pract. 2025 Jul 23;15(8):135. doi: 10.3390/clinpract15080135.
BACKGROUND/OBJECTIVES: Platelet-rich plasma (PRP) is emerging as a safe and effective treatment for facet-mediated pain. Studies have demonstrated reductions in pain and improvements in function, both in the short (3 months) and longer term (6 and 12 months). The mechanisms underlying clinical improvements are largely unknown. It is also unclear whether reported outcomes are due to the PRP administered or concurrently applied rehabilitation.
A prospective case series was conducted in a single, multidisciplinary chronic pain centre. Forty-two participants with chronic WAD and cervical facet-mediated pain who received PRP (64% female; mean age (SD) 42.8 (11.6) years; median WAD duration [IQR] 23 [18,29] mths), attended rehabilitation, and reported successful outcomes 3 months post-PRP fulfilled the inclusion criteria. Measures of pain, cervical isometric strength, and range of motion were collected at baseline and 3 months post-PRP. Mediation analyses were performed to determine how these factors influenced disability.
Participants demonstrated clinically significant and relevant improvements in pain, disability, and isometric strength measures (all < 0.01). Causative mediation analyses demonstrated independent direct, but not indirect, effects of both pain and strength on disability (both < 0.001), with no direct or indirect effects of cervical ROM on disability.
背景/目的：富血小板血浆（PRP）正在成为一种治疗小关节介导性疼痛的安全有效方法。研究表明，无论是在短期（3个月）还是长期（6个月和12个月），疼痛均有所减轻，功能也有所改善。临床改善的潜在机制在很大程度上尚不清楚。同样不清楚所报告的结果是由于注射了PRP还是同时进行的康复治疗所致。
在一个单一的多学科慢性疼痛中心进行了一项前瞻性病例系列研究。42名患有慢性挥鞭样损伤相关疾病（WAD）和颈椎小关节介导性疼痛且接受PRP治疗的参与者（64%为女性；平均年龄（标准差）42.8（11.6）岁；WAD持续时间中位数[四分位间距]23[18,29]个月），接受了康复治疗，且在PRP治疗后3个月报告有成功结果，符合纳入标准。在基线时和PRP治疗后3个月收集疼痛、颈椎等长肌力和活动范围的测量数据。进行中介分析以确定这些因素如何影响残疾情况。
参与者在疼痛、残疾和等长肌力测量方面均表现出具有临床意义且相关的改善（均P<0.01）。因果中介分析表明，疼痛和肌力对残疾均有独立的直接影响，但无间接影响（均P<0.001），颈椎活动范围对残疾无直接或间接影响。
