Research progress of platelet-rich plasma in treatment of discogenic low back pain_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HUANG Huagui , WANG Jinzuo , LIU Xin , ZHANG Jing , SUN Tianze ,  LI Zhonghai

Department of Orthopedics, the First Affiliated Hospital of Dalian Medical University, Dalian Liaoning, 116011, P. R. China;

Corresponding author：

LI Zhonghai, Email: lizhonghaispine@126.com

Keywords：

Platelet-rich plasma; discogenic low back pain; intervertebral disc degeneration; growth factor

DOI：

10.7507/1002-1892.202211047

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the research progress of platelet-rich plasma (PRP) for the treatment of discogenic low back pain (DLBP). Methods The literature on the treatment of DLBP with PRP was extensively reviewed, and the classification, treatment mechanism, in vitro and in vivo experiments and clinical trial progress of PRP were summarized. Results According to the PRP composition, preparation methods, and physicochemical properties, there are five commonly used PRP classification systems at present. PRP is involved in delaying or reversing the progress of disc degeneration and pain control by promoting the regeneration of nucleus pulposus cells, increasing the synthesis of extracellular matrix, and regulating the internal microenvironment of degenerative intervertebral disc. Although several in vitro and in vivo studies have confirmed that PRP can promote disc regeneration and repair, significantly relieve pain, and even improve the mobility of DLBP patients. But the contrary conclusion has been reached in a few studies, and there are limitations to the application of PRP. Conclusion Current studies have confirmed the effectiveness and safety of PRP in the treatment of DLBP and intervertebral disc degeneration, as well as the advantages of PRP in terms of ease of extraction and preparation, low immunological rejection, high regenerative and repair capacity, and the ability to compensate for the shortcomings of traditional treatment modalities. However, relevant studies are still needed to further optimize PRP preparation methods, unify systematic classification guidelines, and clarify its long-term effectiveness.

Citation： HUANG Huagui, WANG Jinzuo, LIU Xin, ZHANG Jing, SUN Tianze, LI Zhonghai. Research progress of platelet-rich plasma in treatment of discogenic low back pain. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(3): 377-382. doi: 10.7507/1002-1892.202211047 Copy

1.	GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2018, 392(10159): 1789-1858.
2.	Koetsier E, van Kuijk SMJ, Maino P, et al. Efficacy of the Gelstix nucleus augmentation device for the treatment of chronic discogenic low back pain: protocol for a randomised, sham-controlled, double-blind, multicentre trial. BMJ Open, 2022, 12(3): e053772. doi: 10.1136/bmjopen-2021-053772.
3.	Geurts JW, Willems PC, Kallewaard JW, et al. The impact of chronic discogenic low back pain: Costs and patients’ burden. Pain Res Manag, 2018, 2018: 4696180. doi: 10.1155/2018/4696180.
4.	Knezevic NN, Candido KD, Vlaeyen JWS, et al. Low back pain. Lancet, 2021, 398(10294): 78-92.
5.	Cheung KM, Karppinen J, Chan D, et al. Prevalence and pattern of lumbar magnetic resonance imaging changes in a population study of one thousand forty-three individuals. Spine (Phila Pa 1976), 2009, 34(9): 934-940.
6.	Frost BA, Camarero-Espinosa S, Foster EJ. Materials for the spine: Anatomy, problems, and solutions. Materials (Basel), 2019, 12(2): 253. doi: 10.3390/ma12020253.
7.	Dowdell J, Erwin M, Choma T, et al. Intervertebral disk degeneration and repair. Neurosurgery, 2017, 80(3S): S46-S54.
8.	Vo NV, Hartman RA, Patil PR, et al. Molecular mechanisms of biological aging in intervertebral discs. J Orthop Res, 2016, 34(8): 1289-1306.
9.	Manchikanti L, Soin A, Benyamin RM, et al. An update of the systematic appraisal of the accuracy and utility of discography in chronic spinal pain. Pain Physician, 2018, 21(2): 91-110.
10.	Hoang DM, Pham PT, Bach TQ, et al. Stem cell-based therapy for human diseases. Signal Transduct Target Ther, 2022, 7(1): 272. doi: 10.1038/s41392-022-01134-4.
11.	Everts P, Onishi K, Jayaram P, et al. Platelet-rich plasma: New performance understandings and therapeutic considerations in 2020. Int J Mol Sci, 2020, 21(20): 7794. doi: 10.3390/ijms21207794.
12.	Verma R, Kumar S, Garg P, et al. Platelet-rich plasma: a comparative and economical therapy for wound healing and tissue regeneration. Cell Tissue Bank, 2022: 1-22.
13.	Linertová R, Del Pino-Sedeño T, Pérez LG, et al. Cost-effectiveness of platelet-rich plasma for diabetic foot ulcer in Spain. Int J Low Extrem Wounds, 2021, 20(2): 119-127.
14.	Fang J, Wang X, Jiang W, et al. Platelet-rich plasma therapy in the treatment of diseases associated with orthopedic injuries. Tissue Eng Part B Rev, 2020, 26(6): 571-585.
15.	Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol, 2009, 27(3): 158-167.
16.	DeLong JM, Russell RP, Mazzocca AD. Platelet-rich plasma: the PAW classification system. Arthroscopy, 2012, 28(7): 998-1009.
17.	Martin P, Leibovich SJ. Inflammatory cells during wound repair: the good, the bad and the ugly. Trends Cell Biol, 2005, 15(11): 599-607.
18.	Mautner K, Malanga GA, Smith J, et al. A call for a standard classification system for future biologic research: the rationale for new PRP nomenclature. PM R, 2015, 7(4 Suppl): S53-S59.
19.	Magalon J, Chateau AL, Bertrand B, et al. DEPA classification: a proposal for standardising PRP use and a retrospective application of available devices. BMJ Open Sport Exerc Med, 2016, 2(1): e000060. doi: 10.1136/bmjsem-2015-000060.
20.	Lana JFSD, Purita J, Paulus C, et al. Contributions for classification of platelet rich plasma-proposal of a new classification: MARSPILL. Regen Med, 2017, 12(5): 565-574.
21.	Cecerska-Heryć E, Goszka M, Serwin N, et al. Applications of the regenerative capacity of platelets in modern medicine. Cytokine Growth Factor Rev, 2022, 64: 84-94.
22.	Cecerska-Heryć E, Heryć R, Wiśniewska M, et al. Regenerative potential of platelets in patients with chronic kidney disease. Int Urol Nephrol, 2019, 51(10): 1831-1840.
23.	Gremmel T, Frelinger AL, Michelson AD. Platelet physiology. Semin Thromb Hemost, 2016, 42(3): 191-204.
24.	Nurden AT. The biology of the platelet with special reference to inflammation, wound healing and immunity. Front Biosci (Landmark Ed), 2018, 23(4): 726-751.
25.	Bhatia R, Chopra G. Efficacy of platelet rich plasma via lumbar epidural route in chronic prolapsed intervertebral disc patients-a pilot study. J Clin Diagn Res, 2016, 10(9): UC05-UC07.
26.	Etulain J. Platelets in wound healing and regenerative medicine. Platelets, 2018, 29(6): 556-568.
27.	Oneto P, Etulain J. PRP in wound healing applications. Platelets, 2021, 32(2): 189-199.
28.	Etulain J, Negrotto S, Schattner M. Role of platelets in angiogenesis in health and disease. Current Angiogenesis, 2014, 3(1): 48-57.
29.	Everts PA, van Erp A, DeSimone A, et al. Platelet rich plasma in orthopedic surgical medicine. Platelets, 2021, 32(2): 163-174.
30.	Akeda K, An HS, Okuma M, et al. Platelet-rich plasma stimulates porcine articular chondrocyte proliferation and matrix biosynthesis. Osteoarthritis Cartilage, 2006, 14(12): 1272-1280.
31.	Akeda K, Yamada J, Linn ET, et al. Platelet-rich plasma in the management of chronic low back pain: a critical review. J Pain Res, 2019, 12: 753-767.
32.	Chang Y, Yang M, Ke S, et al. Effect of platelet-rich plasma on intervertebral disc degeneration in vivo and in vitro: A critical review. Oxid Med Cell Longev, 2020, 2020: 8893819. doi: 10.1155/2020/8893819.
33.	Dregalla RC, Uribe Y, Bodor M. Human mesenchymal stem cells respond differentially to platelet preparations and synthesize hyaluronic acid in nucleus pulposus extracellular matrix. Spine J, 2020, 20(11): 1850-1860.
34.	Yang H, Yuan C, Wu C, et al. The role of TGF-β1/Smad2/3 pathway in platelet-rich plasma in retarding intervertebral disc degeneration. J Cell Mol Med, 2016, 20(8): 1542-1549.
35.	Kim YG, Choi J, Kim K. Mesenchymal stem cell-derived exosomes for effective cartilage tissue repair and treatment of osteoarthritis. Biotechnol J, 2020, 15(12): e2000082. doi: 10.1002/biot.202000082.
36.	Xu J, Xie G, Yang W, et al. Platelet-rich plasma attenuates intervertebral disc degeneration via delivering miR-141-3p-containing exosomes. Cell Cycle, 2021, 20(15): 1487-1499.
37.	Qian J, Wang X, Su G, et al. Platelet-rich plasma-derived exosomes attenuate intervertebral disc degeneration by promoting NLRP3 autophagic degradation in macrophages. Int Immunopharmacol, 2022, 110: 108962. doi: 10.1016/j.intimp.2022.108962.
38.	Hu B, Wang L, Sun N, et al. Mechanism of Mir-25-3P carried by extracellular vesicles derived from platelet-rich plasma in IL-1β-induced nucleus pulposus cell degeneration via the SOX4/CXCR7 axis. Shock, 2022, 58(1): 56-67.
39.	Zhang Z, Ma J, Ren D, et al. A possible injectable tissue engineered nucleus pulposus constructed with platelet-rich plasma and ADSCs in vitro. J Orthop Surg Res, 2020, 15(1): 311. doi: 10.1186/s13018-020-01840-1.
40.	Russo F, Ambrosio L, Peroglio M, et al. A hyaluronan and platelet-rich plasma hydrogel for mesenchymal stem cell delivery in the intervertebral disc: An organ culture study. Int J Mol Sci, 2021, 22(6): 2963. doi: 10.3390/ijms22062963.
41.	Hou Y, Shi G, Shi J, et al. Study design: in vitro and in vivo assessment of bone morphogenic protein 2 combined with platelet-rich plasma on treatment of disc degeneration. Int Orthop, 2016, 40(6): 1143-1155.
42.	Ma C, Wang R, Zhao D, et al. Efficacy of platelet-rich plasma containing xenogenic adipose tissue-derived stromal cells on restoring intervertebral disc degeneration: A preclinical study in a rabbit model. Pain Res Manag, 2019, 2019: 6372356. doi: 10.1155/2019/6372356.
43.	Gelalis ID, Christoforou G, Charchanti A, et al. Autologous platelet-rich plasma (PRP) effect on intervertebral disc restoration: an experimental rabbit model. Eur J Orthop Surg Traumatol, 2019, 29(3): 545-551.
44.	Hartung T. Thoughts on limitations of animal models. Parkinsonism Relat Disord, 2008, 14 Suppl 2: S81-83.
45.	Akeda K, Ohishi K, Masuda K, et al. Intradiscal injection of autologous platelet-rich plasma releasate to treat discogenic low back pain: A preliminary clinical trial. Asian Spine J, 2017, 11(3): 380-389.
46.	Akeda K, Ohishi K, Takegami N, et al. Platelet-rich plasma releasate versus corticosteroid for the treatment of discogenic low back pain: A double-blind randomized controlled trial. J Clin Med, 2022, 11(2): 304. doi: 10.3390/jcm11020304.
47.	Ruiz-Lopez R, Tsai YC. A randomized double-blind controlled pilot study comparing leucocyte-rich platelet-rich plasma and corticosteroid in caudal epidural injection for complex chronic degenerative spinal pain. Pain Pract, 2020, 20(6): 639-646.
48.	Xu Z, Wu S, Li X, et al. Ultrasound-guided transforaminal injections of platelet-rich plasma compared with steroid in lumbar disc herniation: A prospective, randomized, controlled study. Neural Plast, 2021, 2021: 5558138. doi: 10.1155/2021/5558138.
49.	Zielinski MA, Evans NE, Bae H, et al. Safety and efficacy of platelet rich plasma for treatment of lumbar discogenic pain: A prospective, multicenter, randomized, double-blind study. Pain Physician, 2022, 25(1): 29-34.
50.	Zhang J, Liu D, Gong Q, et al. Intradiscal autologous platelet-rich plasma injection for discogenic low back pain: A clinical trial. Biomed Res Int, 2022, 2022: 9563693. doi: 10.1155/2022/9563693.
51.	Jain D, Goyal T, Verma N, et al. Intradiscal platelet-rich plasma injection for discogenic low back pain and correlation with platelet concentration: A prospective clinical trial. Pain Med, 2020, 21(11): 2719-2725.
52.	Lutz C, Cheng J, Prysak M, et al. Clinical outcomes following intradiscal injections of higher-concentration platelet-rich plasma in patients with chronic lumbar discogenic pain. Int Orthop, 2022, 46(6): 1381-1385.
53.	Akeda K, Takegami N, Yamada J, et al. Platelet-rich plasma-releasate (PRPr) for the treatment of discogenic low back pain patients: Long-term follow-up survey. Medicina (Kaunas), 2022, 58(3): 428. doi: 10.3390/medicina58030428.
54.	Cheng J, Santiago KA, Nguyen JT, et al. Treatment of symptomatic degenerative intervertebral discs with autologous platelet-rich plasma: follow-up at 5-9 years. Regen Med, 2019, 14(9): 831-840.
55.	Lee JW, Lee E, Lee GY, et al. Epidural steroid injection-related events requiring hospitalisation or emergency room visits among 52, 935 procedures performed at a single centre. Eur Radiol, 2018, 28(1): 418-427.

1. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2018, 392(10159): 1789-1858.
2. Koetsier E, van Kuijk SMJ, Maino P, et al. Efficacy of the Gelstix nucleus augmentation device for the treatment of chronic discogenic low back pain: protocol for a randomised, sham-controlled, double-blind, multicentre trial. BMJ Open, 2022, 12(3): e053772. doi: 10.1136/bmjopen-2021-053772.
3. Geurts JW, Willems PC, Kallewaard JW, et al. The impact of chronic discogenic low back pain: Costs and patients’ burden. Pain Res Manag, 2018, 2018: 4696180. doi: 10.1155/2018/4696180.
4. Knezevic NN, Candido KD, Vlaeyen JWS, et al. Low back pain. Lancet, 2021, 398(10294): 78-92.
5. Cheung KM, Karppinen J, Chan D, et al. Prevalence and pattern of lumbar magnetic resonance imaging changes in a population study of one thousand forty-three individuals. Spine (Phila Pa 1976), 2009, 34(9): 934-940.
6. Frost BA, Camarero-Espinosa S, Foster EJ. Materials for the spine: Anatomy, problems, and solutions. Materials (Basel), 2019, 12(2): 253. doi: 10.3390/ma12020253.
7. Dowdell J, Erwin M, Choma T, et al. Intervertebral disk degeneration and repair. Neurosurgery, 2017, 80(3S): S46-S54.
8. Vo NV, Hartman RA, Patil PR, et al. Molecular mechanisms of biological aging in intervertebral discs. J Orthop Res, 2016, 34(8): 1289-1306.
9. Manchikanti L, Soin A, Benyamin RM, et al. An update of the systematic appraisal of the accuracy and utility of discography in chronic spinal pain. Pain Physician, 2018, 21(2): 91-110.
10. Hoang DM, Pham PT, Bach TQ, et al. Stem cell-based therapy for human diseases. Signal Transduct Target Ther, 2022, 7(1): 272. doi: 10.1038/s41392-022-01134-4.
11. Everts P, Onishi K, Jayaram P, et al. Platelet-rich plasma: New performance understandings and therapeutic considerations in 2020. Int J Mol Sci, 2020, 21(20): 7794. doi: 10.3390/ijms21207794.
12. Verma R, Kumar S, Garg P, et al. Platelet-rich plasma: a comparative and economical therapy for wound healing and tissue regeneration. Cell Tissue Bank, 2022: 1-22.
13. Linertová R, Del Pino-Sedeño T, Pérez LG, et al. Cost-effectiveness of platelet-rich plasma for diabetic foot ulcer in Spain. Int J Low Extrem Wounds, 2021, 20(2): 119-127.
14. Fang J, Wang X, Jiang W, et al. Platelet-rich plasma therapy in the treatment of diseases associated with orthopedic injuries. Tissue Eng Part B Rev, 2020, 26(6): 571-585.
15. Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol, 2009, 27(3): 158-167.
16. DeLong JM, Russell RP, Mazzocca AD. Platelet-rich plasma: the PAW classification system. Arthroscopy, 2012, 28(7): 998-1009.
17. Martin P, Leibovich SJ. Inflammatory cells during wound repair: the good, the bad and the ugly. Trends Cell Biol, 2005, 15(11): 599-607.
18. Mautner K, Malanga GA, Smith J, et al. A call for a standard classification system for future biologic research: the rationale for new PRP nomenclature. PM R, 2015, 7(4 Suppl): S53-S59.
19. Magalon J, Chateau AL, Bertrand B, et al. DEPA classification: a proposal for standardising PRP use and a retrospective application of available devices. BMJ Open Sport Exerc Med, 2016, 2(1): e000060. doi: 10.1136/bmjsem-2015-000060.
20. Lana JFSD, Purita J, Paulus C, et al. Contributions for classification of platelet rich plasma-proposal of a new classification: MARSPILL. Regen Med, 2017, 12(5): 565-574.
21. Cecerska-Heryć E, Goszka M, Serwin N, et al. Applications of the regenerative capacity of platelets in modern medicine. Cytokine Growth Factor Rev, 2022, 64: 84-94.
22. Cecerska-Heryć E, Heryć R, Wiśniewska M, et al. Regenerative potential of platelets in patients with chronic kidney disease. Int Urol Nephrol, 2019, 51(10): 1831-1840.
23. Gremmel T, Frelinger AL, Michelson AD. Platelet physiology. Semin Thromb Hemost, 2016, 42(3): 191-204.
24. Nurden AT. The biology of the platelet with special reference to inflammation, wound healing and immunity. Front Biosci (Landmark Ed), 2018, 23(4): 726-751.
25. Bhatia R, Chopra G. Efficacy of platelet rich plasma via lumbar epidural route in chronic prolapsed intervertebral disc patients-a pilot study. J Clin Diagn Res, 2016, 10(9): UC05-UC07.
26. Etulain J. Platelets in wound healing and regenerative medicine. Platelets, 2018, 29(6): 556-568.
27. Oneto P, Etulain J. PRP in wound healing applications. Platelets, 2021, 32(2): 189-199.
28. Etulain J, Negrotto S, Schattner M. Role of platelets in angiogenesis in health and disease. Current Angiogenesis, 2014, 3(1): 48-57.
29. Everts PA, van Erp A, DeSimone A, et al. Platelet rich plasma in orthopedic surgical medicine. Platelets, 2021, 32(2): 163-174.
30. Akeda K, An HS, Okuma M, et al. Platelet-rich plasma stimulates porcine articular chondrocyte proliferation and matrix biosynthesis. Osteoarthritis Cartilage, 2006, 14(12): 1272-1280.
31. Akeda K, Yamada J, Linn ET, et al. Platelet-rich plasma in the management of chronic low back pain: a critical review. J Pain Res, 2019, 12: 753-767.
32. Chang Y, Yang M, Ke S, et al. Effect of platelet-rich plasma on intervertebral disc degeneration in vivo and in vitro: A critical review. Oxid Med Cell Longev, 2020, 2020: 8893819. doi: 10.1155/2020/8893819.
33. Dregalla RC, Uribe Y, Bodor M. Human mesenchymal stem cells respond differentially to platelet preparations and synthesize hyaluronic acid in nucleus pulposus extracellular matrix. Spine J, 2020, 20(11): 1850-1860.
34. Yang H, Yuan C, Wu C, et al. The role of TGF-β1/Smad2/3 pathway in platelet-rich plasma in retarding intervertebral disc degeneration. J Cell Mol Med, 2016, 20(8): 1542-1549.
35. Kim YG, Choi J, Kim K. Mesenchymal stem cell-derived exosomes for effective cartilage tissue repair and treatment of osteoarthritis. Biotechnol J, 2020, 15(12): e2000082. doi: 10.1002/biot.202000082.
36. Xu J, Xie G, Yang W, et al. Platelet-rich plasma attenuates intervertebral disc degeneration via delivering miR-141-3p-containing exosomes. Cell Cycle, 2021, 20(15): 1487-1499.
37. Qian J, Wang X, Su G, et al. Platelet-rich plasma-derived exosomes attenuate intervertebral disc degeneration by promoting NLRP3 autophagic degradation in macrophages. Int Immunopharmacol, 2022, 110: 108962. doi: 10.1016/j.intimp.2022.108962.
38. Hu B, Wang L, Sun N, et al. Mechanism of Mir-25-3P carried by extracellular vesicles derived from platelet-rich plasma in IL-1β-induced nucleus pulposus cell degeneration via the SOX4/CXCR7 axis. Shock, 2022, 58(1): 56-67.
39. Zhang Z, Ma J, Ren D, et al. A possible injectable tissue engineered nucleus pulposus constructed with platelet-rich plasma and ADSCs in vitro. J Orthop Surg Res, 2020, 15(1): 311. doi: 10.1186/s13018-020-01840-1.
40. Russo F, Ambrosio L, Peroglio M, et al. A hyaluronan and platelet-rich plasma hydrogel for mesenchymal stem cell delivery in the intervertebral disc: An organ culture study. Int J Mol Sci, 2021, 22(6): 2963. doi: 10.3390/ijms22062963.
41. Hou Y, Shi G, Shi J, et al. Study design: in vitro and in vivo assessment of bone morphogenic protein 2 combined with platelet-rich plasma on treatment of disc degeneration. Int Orthop, 2016, 40(6): 1143-1155.
42. Ma C, Wang R, Zhao D, et al. Efficacy of platelet-rich plasma containing xenogenic adipose tissue-derived stromal cells on restoring intervertebral disc degeneration: A preclinical study in a rabbit model. Pain Res Manag, 2019, 2019: 6372356. doi: 10.1155/2019/6372356.
43. Gelalis ID, Christoforou G, Charchanti A, et al. Autologous platelet-rich plasma (PRP) effect on intervertebral disc restoration: an experimental rabbit model. Eur J Orthop Surg Traumatol, 2019, 29(3): 545-551.
44. Hartung T. Thoughts on limitations of animal models. Parkinsonism Relat Disord, 2008, 14 Suppl 2: S81-83.
45. Akeda K, Ohishi K, Masuda K, et al. Intradiscal injection of autologous platelet-rich plasma releasate to treat discogenic low back pain: A preliminary clinical trial. Asian Spine J, 2017, 11(3): 380-389.
46. Akeda K, Ohishi K, Takegami N, et al. Platelet-rich plasma releasate versus corticosteroid for the treatment of discogenic low back pain: A double-blind randomized controlled trial. J Clin Med, 2022, 11(2): 304. doi: 10.3390/jcm11020304.
47. Ruiz-Lopez R, Tsai YC. A randomized double-blind controlled pilot study comparing leucocyte-rich platelet-rich plasma and corticosteroid in caudal epidural injection for complex chronic degenerative spinal pain. Pain Pract, 2020, 20(6): 639-646.
48. Xu Z, Wu S, Li X, et al. Ultrasound-guided transforaminal injections of platelet-rich plasma compared with steroid in lumbar disc herniation: A prospective, randomized, controlled study. Neural Plast, 2021, 2021: 5558138. doi: 10.1155/2021/5558138.
49. Zielinski MA, Evans NE, Bae H, et al. Safety and efficacy of platelet rich plasma for treatment of lumbar discogenic pain: A prospective, multicenter, randomized, double-blind study. Pain Physician, 2022, 25(1): 29-34.
50. Zhang J, Liu D, Gong Q, et al. Intradiscal autologous platelet-rich plasma injection for discogenic low back pain: A clinical trial. Biomed Res Int, 2022, 2022: 9563693. doi: 10.1155/2022/9563693.
51. Jain D, Goyal T, Verma N, et al. Intradiscal platelet-rich plasma injection for discogenic low back pain and correlation with platelet concentration: A prospective clinical trial. Pain Med, 2020, 21(11): 2719-2725.
52. Lutz C, Cheng J, Prysak M, et al. Clinical outcomes following intradiscal injections of higher-concentration platelet-rich plasma in patients with chronic lumbar discogenic pain. Int Orthop, 2022, 46(6): 1381-1385.
53. Akeda K, Takegami N, Yamada J, et al. Platelet-rich plasma-releasate (PRPr) for the treatment of discogenic low back pain patients: Long-term follow-up survey. Medicina (Kaunas), 2022, 58(3): 428. doi: 10.3390/medicina58030428.
54. Cheng J, Santiago KA, Nguyen JT, et al. Treatment of symptomatic degenerative intervertebral discs with autologous platelet-rich plasma: follow-up at 5-9 years. Regen Med, 2019, 14(9): 831-840.
55. Lee JW, Lee E, Lee GY, et al. Epidural steroid injection-related events requiring hospitalisation or emergency room visits among 52, 935 procedures performed at a single centre. Eur Radiol, 2018, 28(1): 418-427.

Chinese Journal of Reparative and Reconstructive Surgery

Research progress of platelet-rich plasma in treatment of discogenic low back pain

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content