title: Lumbar Intradiskal Platelet-Rich Plasma (PRP) Injections: A Prospective, Double-Blind, Randomized Controlled Study.
abstract: OBJECTIVE
  To determine whether single injections of autologous platelet-rich plasma (PRP) into symptomatic degenerative intervertebral disks will improve participant-reported pain and function.
  
  
  METHODS
  Prospective, double-blind, randomized controlled study.
  
  
  METHODS
  Outpatient physiatric spine practice.
  
  
  METHODS
  Adults with chronic (≥6 months), moderate-to-severe lumbar diskogenic pain that was unresponsive to conservative treatment.
  
  
  METHODS
  Participants were randomized to receive intradiskal PRP or contrast agent after provocative diskography. Data on pain, physical function, and participant satisfaction were collected at 1 week, 4 weeks, 8 weeks, 6 months, and 1 year. Participants in the control group who did not improve at 8 weeks were offered the option to receive PRP and subsequently followed.
  
  
  METHODS
  Functional Rating Index (FRI), Numeric Rating Scale (NRS) for pain, the pain and physical function domains of the 36-item Short Form Health Survey, and the modified North American Spine Society (NASS) Outcome Questionnaire were used.
  
  
  RESULTS
  Forty-seven participants (29 in the treatment group, 18 in the control group) were analyzed by an independent observer with a 92% follow-up rate. Over 8 weeks of follow-up, there were statistically significant improvements in participants who received intradiskal PRP with regards to pain (NRS Best Pain) (P = .02), function (FRI) (P = .03), and patient satisfaction (NASS Outcome Questionnaire) (P = .01) compared with controls. No adverse events of disk space infection, neurologic injury, or progressive herniation were reported following the injection of PRP.
  
  
  CONCLUSIONS
  Participants who received intradiskal PRP showed significant improvements in FRI, NRS Best Pain, and NASS patient satisfaction scores over 8 weeks compared with controls. Those who received PRP maintained significant improvements in FRI scores through at least 1 year of follow-up. Although these results are promising, further studies are needed to define the subset of participants most likely to respond to biologic intradiskal treatment and the ideal cellular characteristics of the intradiskal PRP injectate.
authors: Hospital for Special Surgery, Physiatry Department, New York, NY(∗).
authors: Yetsa A
authors: YA
authors: Tuakli-Wosornu
authors: Hospital for Special Surgery, Physiatry Department, New York, NY(†).
authors: Alon
authors: A
authors: Terry
authors: Hospital for Special Surgery, Physiatry Department, New York, NY(‡).
authors: Kwadwo
authors: K
authors: Boachie-Adjei
authors: Hospital for Special Surgery, Physiatry Department, New York, NY(§).
authors: Julian R
authors: JR
authors: Harrison
authors: Hospital for Special Surgery, Physiatry Department, New York, NY(‖).
authors: Caitlin K
authors: CK
authors: Gribbin
authors: Hospital for Special Surgery, Physiatry Department, New York, NY(¶).
authors: Elizabeth E
authors: EE
authors: LaSalle
authors: Hospital for Special Surgery, Epidemiology and Biostatistics Department, New York, NY(#).
authors: Joseph T
authors: JT
authors: Nguyen
authors: Hospital for Special Surgery, Physiatry Department, New York, NY(∗∗).
authors: Jennifer L
authors: JL
authors: Solomon
authors: Physiatry Department, Hospital for Special Surgery, New York, NY; and Department of Rehabilitation Medicine, Weill Cornell Medical College, New York, NY(††). Electronic address: LutzG@hss.edu.
authors: Gregory E
authors: GE
authors: Lutz
mesh_terms: D000328:Adult; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007278:Injections, Spinal; D007403:Intervertebral Disc; D017116:Low Back Pain / Q000175:diagnosis / Q000628:therapy*; D008159:Lumbar Vertebrae; D008297:Male; D009192:Myelography; D010147:Pain Measurement; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: disc; intradiscal