Comparison of interlaminar CT-guided epidural platelet-rich plasma versus steroid injection in patients with lumbar radicular pain.

Details

Serval ID
serval:BIB_C47CC4E6D939
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Comparison of interlaminar CT-guided epidural platelet-rich plasma versus steroid injection in patients with lumbar radicular pain.
Journal
European radiology
Author(s)
Bise S., Dallaudiere B., Pesquer L., Pedram M., Meyer P., Antoun M.B., Hocquelet A., Silvestre A.
ISSN
1432-1084 (Electronic)
ISSN-L
0938-7994
Publication state
Published
Issued date
06/2020
Peer-reviewed
Oui
Volume
30
Number
6
Pages
3152-3160
Language
english
Notes
Publication types: Comparative Study ; Journal Article
Publication Status: ppublish
Abstract
The treatment of persistent lumbar radicular pain (LRP) by CT-guided epidural steroid injection (ESI) is extensively used and associated with rare but serious complications. Platelet-rich plasma (PRP), which has recently been shown to favor healing and the anti-inflammatory process by delivering growth factors and cytokines, might be an alternative and potentially safer option. We compared the efficacy of interlaminar CT-guided epidural PRP injections (EPRPI) and ESI in the treatment of persistent LRP (> 6 weeks).
In this non-randomized comparative study, patients were prospectively assessed for pain using the numerical rating scale (NRS) and for function with the Oswestry Disability Index (ODI) before and 6 weeks after treatment. Related paired and independent t tests were used for intra- and inter-group comparisons.
A total of 60 patients were included in 2 groups (n = 30 EPRPI, n = 30 ESI). A statistically significant improvement was found in both groups at 6 weeks (mean NRS values 5.7 (± 2.36) at D0 and 3.7 (± 2.3) at 6 weeks (p < 0.01); mean ODI values 30 (± 11) at D0 and 21 (± 13) at 6 weeks (p < 0.01)). No significant difference was observed in the decrease in NRS and ODI scores between the 2 groups at 6 weeks (p = 0.848 and p = 0.314 for the NRS and ODI, respectively). No major complications were noted.
The results of CT-guided interlaminar EPRPI are similar to ESI for the treatment of persistent LRP and could be a safer option.
• Treatment of persistent lumbar radicular pain by CT-guided epidural steroid injections is associated with rare but serious complications. • By promoting an anti-inflammatory process, epidural platelet-rich plasma injections might be an alternative treatment of persistent radicular pain. • Platelet-rich plasma CT-guided epidural injections are similar to steroid for the treatment of lumbar radicular pain at 6 weeks post-procedure and could be a safer option.
Keywords
Female, Humans, Injections, Epidural/adverse effects, Low Back Pain/drug therapy, Low Back Pain/etiology, Low Back Pain/therapy, Lumbosacral Region, Male, Middle Aged, Pain Management/methods, Platelet-Rich Plasma, Prospective Studies, Radiculopathy/complications, Steroids/administration & dosage, Steroids/adverse effects, Tomography, X-Ray Computed/methods, Treatment Outcome, Back pain, Lumbar, Platelet-rich plasma, Regenerative, Spine (Phila Pa 1976)
Pubmed
Web of science
Create date
27/02/2020 14:39
Last modification date
06/04/2024 7:23
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