Intradiscal Platelet-Rich Plasma Injection for Discogenic Low Back Pain and Correlation with Platelet Concentration: A Prospective Clinical Trial

• Published in: Pain medicine (Malden, Mass.) Vol. 21; no. 11; pp. 2719 - 2725
• Main Authors: Jain, Dhruv, Goyal, Titiksha, Verma, Nimisha, Paswan, Anil Kumar, Dubey, Rajeev Kumar
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.11.2020
• Subjects: Back pain; Blood platelets; Care and treatment; Chronic pain; Clinical trials; Humans; Injection; Injections, Spinal; Intervertebral Disc Displacement; Low back pain; Low Back Pain - therapy; Morbidity; Patients; Platelet-Rich Plasma; Platelet-rich plasma therapy; Platelets; Prospective Studies; Spinal diseases; Testing; Treatment Outcome; India; Discogenic; Platelet-Rich Plasma; Intradiscal; Platelet Concentration; Low Back; Chronic Pain
• ISSN: 1526-2375; 1526-4637; 1526-4637
• DOI: 10.1093/pm/pnaa254

Abstract Objective Discogenic pain is common cause of low back ache and may result in significant morbidity. Platelet-rich plasma (PRP) is an upcoming regenerative therapy that has treatment potential for this condition. The objective of this study was to correlate platelet concentration in intradiscal PRP injection with improvement in low back pain and functional status at three and six months. Design Prospective single-arm interventional study. Setting Outpatient pain clinic and operation theater. Subjects Twenty-five patients with discogenic pain diagnosed by clinical means and imaging with confirmation by provocative discography were recruited. Methods The patients received PRP injection at a single or multiple disc levels. Preprocedure numerical rating scale (NRS) pain scores and Oswestry Disability Index (ODI) scores were calculated. Platelet counts of patients and PRP samples were measured. At three and six months postprocedure, NRS and ODI scores were measured, and improvement in these scores was correlated with platelet concentrations in the PRP sample. Results Twenty patients completed the study. The improvement in NRS and ODI scores positively correlated with platelet concentrations in the PRP sample. We determined the correlation coefficient (r) of platelet concentrations with a reduction in NRS at three months (r = 0.65) and six months (r = 0.73) and in ODI score at three months (r = 0.72) and six months (r = 0.7). Conclusions This study supports the use of intradiscal PRP for treatment of discogenic pain with preferably higher platelet counts to elicit a favorable response.