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

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Mar 15;37(3):377-382. doi: 10.7507/1002-1892.202211047.
[Article in Chinese]

Abstract

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.

目的: 总结富血小板血浆(platelet-rich plasma,PRP)用于治疗椎间盘源性腰痛(discogenic low back pain,DLBP)的研究进展。.

方法: 广泛查阅关于PRP治疗DLBP的相关文献,从PRP的分类、治疗机制、体内外实验及临床研究进展等方面进行总结。.

结果: 根据PRP成分、制备方法及理化性质的差异,目前较常用的PRP分类系统大致有五类。PRP通过促进髓核细胞再生、增加细胞外基质合成、调节退变椎间盘内部微环境等方式,参与延缓或逆转椎间盘退变和控制疼痛的过程。尽管多项体内外研究证实PRP可促进椎间盘再生和修复,且能大幅缓解DLBP患者的疼痛甚至改善其行动能力,但在少数研究中仍得出了相反结论,同时PRP的临床应用也存在一定局限性。.

结论: 目前研究证实了PRP治疗DLBP及椎间盘退变的有效性与安全性,同时还证实PRP具有取材及制备便利、免疫排斥反应小、再生和修复能力强以及能弥补传统治疗方式不足等优势;但仍需开展相关研究进一步优化PRP制备方法,统一系统分类准则,明确其远期疗效。.

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

Publication types

  • English Abstract

MeSH terms

  • Humans
  • Intervertebral Disc Degeneration* / therapy
  • Intervertebral Disc*
  • Low Back Pain* / etiology
  • Low Back Pain* / therapy
  • Nucleus Pulposus*
  • Pain Management
  • Platelet-Rich Plasma*

Grants and funding

辽宁省自然科学基金面上项目(2022-MS-322);大连市科技创新基金应用基础项目(2022JJ12SN045)