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Platelet Rich Plasma and Platelet-Related Products in the Treatment of Radiculopathy—A Systematic Review of the Literature

Back pain with radicular symptoms is associated with detrimental physical and emotional functioning and economic burden. Conservative treatments including physical, pharmacologic and injection therapy may not provide clinically significant or long-standing relief. Regenerative medicine research incl...

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Autores principales: Kubrova, Eva, Martinez Alvarez, Gabriel A., Her, Yeng F., Pagan-Rosado, Robert, Qu, Wenchun, D’Souza, Ryan S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9687426/
https://www.ncbi.nlm.nih.gov/pubmed/36359333
http://dx.doi.org/10.3390/biomedicines10112813
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author Kubrova, Eva
Martinez Alvarez, Gabriel A.
Her, Yeng F.
Pagan-Rosado, Robert
Qu, Wenchun
D’Souza, Ryan S.
author_facet Kubrova, Eva
Martinez Alvarez, Gabriel A.
Her, Yeng F.
Pagan-Rosado, Robert
Qu, Wenchun
D’Souza, Ryan S.
author_sort Kubrova, Eva
collection PubMed
description Back pain with radicular symptoms is associated with detrimental physical and emotional functioning and economic burden. Conservative treatments including physical, pharmacologic and injection therapy may not provide clinically significant or long-standing relief. Regenerative medicine research including Platelet rich plasma (PRP), Platelet lysate (PL) or Plasma rich in growth factors (PRGF) continues to develop, however evidence appraisal for treatment of radicular pain remains lacking. Thus, we performed a systematic review to evaluate the effectiveness of epidural steroid injections containing PRP or related products to treat radicular pain. Embase, PubMed/MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar databases were queried. Twelve studies were included in qualitative analysis, consisting of three randomized controlled trials and nine observational studies. The primary outcome was pain intensity, and secondary outcomes included functional improvement, anatomical changes on advanced imaging, and adverse events. All studies identified improved pain intensity and functional outcomes after epidural injection of PRP, PRGF and/or PL. Similar or longer lasting pain relief was noted in the PRP cohort compared to the cohort receiving epidural steroid injections with effects lasting up to 12–24 months. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) analysis revealed a very-low certainty of evidence due to risk of bias, indirectness, and imprecision.
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spelling pubmed-96874262022-11-25 Platelet Rich Plasma and Platelet-Related Products in the Treatment of Radiculopathy—A Systematic Review of the Literature Kubrova, Eva Martinez Alvarez, Gabriel A. Her, Yeng F. Pagan-Rosado, Robert Qu, Wenchun D’Souza, Ryan S. Biomedicines Systematic Review Back pain with radicular symptoms is associated with detrimental physical and emotional functioning and economic burden. Conservative treatments including physical, pharmacologic and injection therapy may not provide clinically significant or long-standing relief. Regenerative medicine research including Platelet rich plasma (PRP), Platelet lysate (PL) or Plasma rich in growth factors (PRGF) continues to develop, however evidence appraisal for treatment of radicular pain remains lacking. Thus, we performed a systematic review to evaluate the effectiveness of epidural steroid injections containing PRP or related products to treat radicular pain. Embase, PubMed/MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar databases were queried. Twelve studies were included in qualitative analysis, consisting of three randomized controlled trials and nine observational studies. The primary outcome was pain intensity, and secondary outcomes included functional improvement, anatomical changes on advanced imaging, and adverse events. All studies identified improved pain intensity and functional outcomes after epidural injection of PRP, PRGF and/or PL. Similar or longer lasting pain relief was noted in the PRP cohort compared to the cohort receiving epidural steroid injections with effects lasting up to 12–24 months. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) analysis revealed a very-low certainty of evidence due to risk of bias, indirectness, and imprecision. MDPI 2022-11-04 /pmc/articles/PMC9687426/ /pubmed/36359333 http://dx.doi.org/10.3390/biomedicines10112813 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Kubrova, Eva
Martinez Alvarez, Gabriel A.
Her, Yeng F.
Pagan-Rosado, Robert
Qu, Wenchun
D’Souza, Ryan S.
Platelet Rich Plasma and Platelet-Related Products in the Treatment of Radiculopathy—A Systematic Review of the Literature
title Platelet Rich Plasma and Platelet-Related Products in the Treatment of Radiculopathy—A Systematic Review of the Literature
title_full Platelet Rich Plasma and Platelet-Related Products in the Treatment of Radiculopathy—A Systematic Review of the Literature
title_fullStr Platelet Rich Plasma and Platelet-Related Products in the Treatment of Radiculopathy—A Systematic Review of the Literature
title_full_unstemmed Platelet Rich Plasma and Platelet-Related Products in the Treatment of Radiculopathy—A Systematic Review of the Literature
title_short Platelet Rich Plasma and Platelet-Related Products in the Treatment of Radiculopathy—A Systematic Review of the Literature
title_sort platelet rich plasma and platelet-related products in the treatment of radiculopathy—a systematic review of the literature
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9687426/
https://www.ncbi.nlm.nih.gov/pubmed/36359333
http://dx.doi.org/10.3390/biomedicines10112813
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