Comparing Platelet‐Rich Plasma and Corticosteroid in Epidural Injection for Degenerative Spinal Pain
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
Progressive degenerative spinal pain is very difficult to deal with. Various different treatment modalities are currently in place to help with managing symptoms, however, there are ongoing efforts to improve pain management.
This study looks to review and compare the efficacy and safety between leucocyte-rich platelet-rich plasma (LR-PRP) and corticosteroid in the treatment of epidural injection for patients with complex chronic degenerative lumbar spinal pain, via a randomized controlled double blinded study.
50 patients were included who met the inclusion criteria. Patients with complex chronic degenerative spinal pain were randomly assigned allocation to receive guided spinal epidural injection of corticosteroid or LR-PRP guidance. Evaluations of low back pain, quality of life, and complications were measured at 1, 3, and 6 months after treatment.
No significant difference was shown at baseline between two groups. Compared with the pretreatment values, there was a significant reduction in the pain scoring in both groups. Lower pain score at 1-month follow-up was detected in patients who received corticosteroid injection. However, the scores were lower in the LR-PRP group at 3- and 6-month follow-up, Possibly identifying that the corticosteroid group presented with short lived results. Study questionnaires measured at 6-month showed significant improvement at all domains in the LR-PRP group. There were no complications or adverse effects related with treatment during 6-month follow-up in either group.
Both autologous LR-PRP and corticosteroid for epidural injections are equally safe and therapeutically effective in patients with complex chronic lumbar spinal pain. However, LR-PRP is superior to corticosteroid for longer pain-relieving effect and improvement in quality of life. This is more than likely the case due to PRP having stimulatory effects on tissue repair.
PRP is a biological treatment created by first obtaining a small amount of blood through peripheral extraction. PRP is developed via concentrating that blood sample through centrifugation, and then administering the concentrated plasma product back into the patient for therapeutic means. The concentrated plasma product contains a high concentration of platelets, which have critical roles in maintaining tissue homeostasis and regulating the inflammation, along with such as bone and cartilage death inhibition, bone and vessel remodeling, inflammation modulation, and collagen synthesis. Because of these properties, PRP has emerged as a viable treatment method for individuals suffering from condition is like new arthritis and low back pain.
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