PRP Spinoplasty for Chronic Low Back Pain With Multiple Pathologies: A Quasi-Experimental Study

The Efficacy and Safety of Platelet Rich Plasma Spinoplasty in the Management of Lower Back Pain Due to Multiple Pathologies: A Quasi-Experimental Study

This study aimed to evaluate the efficacy and safety of a comprehensive, multi-target injection protocol, termed 'PRP Spinoplasty,' for managing chronic LBP stemming from concurrent lumbar disc and facet joint disease with associated muscle spasms.

A quasi-experimental study was conducted on 29 patients with chronic LBP who failed conservative therapy. The PRP Spinoplasty protocol involved a single-session, fluoroscopy-guided administration of autologous PRP to the interlaminar epidural space, affected facet joints, and paraspinal muscle trigger points. Outcomes were assessed using the Numeric Pain Scale (NPS), Oswestry Disability Index (ODI), and Single Assessment Numeric Evaluation (SANE) at baseline and at 1 week, 1 month, 3 months, and 6 months post-procedure.

Inclusion Criteria:

• Individuals of both sexes; ages between 18 and 80 years.
• Lower back pain consistent with lumbosacral radiculopathy, facet arthropathy, and muscle spasms.
• MRI-confirmed lumbar spine pathology (disc disease and/or facet arthropathy).
• Failure to respond to at least 3 months of conservative therapy (NSAIDS and physical therapy).
• Pain score ≥ 6; on the 10-point Numeric Pain Scale (NPS) at baseline.

Exclusion Criteria:

• Presence of local or systemic infection, or fever.
• Diagnosed with cancer within the past 12 months.
• Unable to give a consent.
• History of spinal deformity such as fracture, or severe spinal stenosis causing neurological deficit.
• Presence of lower extremity weakness or urinary tract symptoms related to spinal pathology.
• Previous spinal decompression or fusion surgery at the treatment level.
• Receipt of any spine injection within the previous 12 months.
• Use of NSAIDs within 2 weeks prior to, or 6 weeks following the procedure.
• Use of corticosteroids within 6 weeks prior, or after the procedure.
• Use of anticoagulation or antiplatelet drugs (excluding low-dose Aspirin).
• History of blood disorders.
• History of any major surgery within the past 3 months.