Article

OBJECTIVE: To determine whether single injections of autologous platelet-rich
plasma (PRP) into symptomatic degenerative intervertebral disks will improve
participant-reported pain and function. DESIGN:
Prospective, double-blind,
randomized controlled study. SETTING: Outpatient physiatric spine practice.
PARTICIPANTS: Adults with chronic (>/=6 months), moderate-to-severe lumbar
diskogenic pain that was unresponsive to conservative treatment. METHODS:
Participants were randomized to receive intradiskal PRP or contrast agent after
provocative diskography. Data on pain, physical function, and participant
satisfaction were collected at 1 week, 4 weeks, 8 weeks, 6 months, and 1 year.
Participants in the control group who did not improve at 8 weeks were offered the
option to receive PRP and subsequently followed. MAIN OUTCOME MEASURES:
Functional Rating Index (FRI), Numeric Rating Scale (NRS) for pain, the pain and
physical function domains of the 36-item Short Form Health Survey, and the
modified North American Spine Society (NASS) Outcome Questionnaire were used.
RESULTS: Forty-seven participants (29 in the treatment group, 18 in the control
group) were analyzed by an independent observer with a 92% follow-up rate. Over 8
weeks of follow-up, there were statistically significant improvements in
participants who received intradiskal PRP with regards to pain (NRS Best Pain) (P
= .02), function (FRI) (P = .03), and patient satisfaction (NASS Outcome
Questionnaire) (P = .01) compared with controls. No adverse events of disk space
infection, neurologic injury, or progressive herniation were reported following
the injection of PRP. CONCLUSION: Participants who received intradiskal PRP
showed significant improvements in FRI, NRS Best Pain, and NASS patient
satisfaction scores over 8 weeks compared with controls. Those who received PRP
maintained significant improvements in FRI scores through at least 1 year of
follow-up. Although these results are promising, further studies are needed to
define the subset of participants most likely to respond to biologic intradiskal
treatment and the ideal cellular characteristics of the intradiskal PRP injectate.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS