Journal of Pain Research (Feb 2021)
The Effect of Intradiscal Platelet-Rich Plasma Injection for Management of Discogenic Lower Back Pain: A Meta-Analysis
Abstract
Min Cheol Chang,1 Donghwi Park2 1Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea; 2Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of KoreaCorrespondence: Donghwi ParkDepartment of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunghwndo-Ro, Dong-Gu, Ulsan, 44033, Republic of KoreaTel +82-52-250-7222Fax +82-52-250-7228Email [email protected]: Although several researches of animal and human subjects have yielded promising results regarding intradiscal injection of platelet-rich plasma (PRP) for the management of intervertebral disc (IVD) pathologies, small sample sizes and unstandardized graft preparation procedures hampered these research efforts. Therefore, we conducted a meta-analysis to evaluate the effectiveness of intradiscal PRP injection for the treatment of discogenic lower back pain.Methods: The PubMed, SCOPUS, Embase, and Cochrane Library databases were systematically searched for relevant studies published from January 01, 1980 to December 14, 2020. The keywords used for the search were (platelet-rich plasma) AND (intradiscal OR back pain OR lumbar spine OR discogenic). Filters were used to select studies with human participants; all study designs were included.Results: After the systematic review, three articles, including one randomized control trial and two prospective observational studies, were included in the final analysis. Analysis of changes in visual analogue scale (VAS) scores showed that VAS scores were significantly reduced two and six months after intradiscal PRP injection (two months: standardized mean difference [SMD] = − 0.837, 95% CI = − 1.158 to − 0.516, P < 0.001; six months: SMD = − 1.430, 95% CI = − 2.209 to − 0.652, P < 0.001), but not after one month (SMD = − 0.661, 95% CI = − 1.346 to 0.023, P = 0.058). Regarding changes in Owestry Disability Index (ODI), ODI scores were significantly reduced after six months (SMD = − 0.964, 95% CI = − 1.885 to − 0.043, P = 0.040).Conclusion: Intradiscal PRP injections are effective in relieving pain and improving disabilities caused by discogenic lower back pain. However, the pain-reducing effect significantly manifests two or six months after the injections, but not after one month.Keywords: platelet-rich plasma, discogenic lower back pain, degenerative disc disease, intervertebral disc, review
