Chang MC, Park D The Effect of Intradiscal Platelet-Rich Plasma Injection for Management of Discogenic Lower Back Pain: A Meta-Analysis. J Pain Res. 2021 Feb 19;14:505-512. doi: 10.2147/JPR.S292335. eCollection 2021. (Systematic review)

Objective: Although several researches of animal and human subjects have yielded promising results regarding intradiscal injection of platelet-rich plasma (PRP) for the management of intervertebral disc (IVD) pathologies, small sample sizes and unstandardized graft preparation procedures hampered these research efforts. Therefore, we conducted a meta-analysis to evaluate the effectiveness of intradiscal PRP injection for the treatment of discogenic lower back pain.

Methods: The PubMed, SCOPUS, Embase, and Cochrane Library databases were systematically searched for relevant studies published from January 01, 1980 to December 14, 2020. The keywords used for the search were (platelet-rich plasma) AND (intradiscal OR back pain OR lumbar spine OR discogenic). Filters were used to select studies with human participants; all study designs were included.

Results: After the systematic review, three articles, including one randomized control trial and two prospective observational studies, were included in the final analysis. Analysis of changes in visual analogue scale (VAS) scores showed that VAS scores were significantly reduced two and six months after intradiscal PRP injection (two months: standardized mean difference [SMD] = -0.837, 95% CI = -1.158 to -0.516, P < 0.001; six months: SMD = -1.430, 95% CI = -2.209 to -0.652, P < 0.001), but not after one month (SMD = -0.661, 95% CI = -1.346 to 0.023, P = 0.058). Regarding changes in Owestry Disability Index (ODI), ODI scores were significantly reduced after six months (SMD = -0.964, 95% CI = -1.885 to -0.043, P = 0.040).

Conclusion: Intradiscal PRP injections are effective in relieving pain and improving disabilities caused by discogenic lower back pain. However, the pain-reducing effect significantly manifests two or six months after the injections, but not after one month.

Discipline Area Score
Physician 5 / 7
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Comments from MORE raters

Physician rater

The paper is interesting; nevertheless, the authors could include only 3 studies (two prospective observational, and just one randomized controlled clinical trial), 88 patients. There is probably not enough to reach a definitive conclusion.
Comments from PAIN+ CPN subscribers

Ms. Sandra Ketler (3/26/2021 12:30 PM)

I don't know how readily available this treatment is, so knowing it may help is not useful at all if the treatment is not available.