What is the preclinical evidence on platelet rich plasma and intervertebral disc degeneration?
OBJECTIVE
Intervertebral disc degeneration is a common disease that usually starts from the third decade of life and it represents a significant cause of socio-economic problems. The accepted surgical treatment for disc degeneration is disc removal and vertebral fusion or, in selected cases, intervertebral disc arthroplasty. Several studies have demonstrated the ability of platelet rich plasma (PRP) to stimulate cell proliferation and extracellular matrix regeneration. However, literature results are still limited and more studies are required to clarify the role of PRP in the prevention or in the treatment of degenerative disc disease. The aim of this review is to summarize and critically analyze the current preclinical evidence about the use of PRP in intervertebral disc degeneration.


METHODS
Literature search was performed through various combinations of the following keywords: Intervertebral Disc Degeneration, Platelet Rich Plasma, PRP, Intervertebral disc regeneration. Papers included in our review cover the period between 2006 and 2014. The PRISMA 2009 checklist was followed.


RESULTS
At the end of the review process, 12 articles were included in our final manuscript, including 6 "in vitro" and 6 "in vivo" studies. All the included studies lead to positive preclinical results. No standardization of methodological analysis was observed.


CONCLUSIONS
It is not possible to draw definitive evidence about the use of PRP in IVD regeneration. We advise a proper standardization of the methodological analysis in order to compare the available data and achieve definitive results. This should be the cornerstone for future clinical applications.
Clinica Ortopedica, University of Genoa, IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi, 10 16132, Genoa, Italy. dott.formica@gmail.com.
Matteo
M
Formica
Clinica Ortopedica, University of Genoa, IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi, 10 16132, Genoa, Italy.
Luca
L
Cavagnaro
CVCO, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 420161, Milan, Italy.
Carlo
C
Formica
CBA, Advanced Biotechnology Center, Largo R. Benzi 10, 16132, Genoa, Italy.
Milena
M
Mastrogiacomo
Clinica Ortopedica, University of Genoa, IRCCS AOU San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi, 10 16132, Genoa, Italy.
Marco
M
Basso
Department of Orthopaedics and Trauma Surgery, University Campus Bio-Medico of Rome, Via Álvaro del Portillo 21, Rome, Italy.
Alberto
A
Di Martino
D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000628:therapy*; D053657:Platelet-Rich Plasma
Intervertebral disc degeneration; Intervertebral disc regeneration; PRP; Platelet rich plasma