Biologics for Lumbar Discogenic Pain: 18 Month Follow-up for Safety and Efficacy

Abstract

The primary objective of this paper is to evaluate safety and effectiveness of platelet rich plasma (PRP) and bone marrow concentrate (BMC) injections in the lumbar intervertebral disc. The secondary objective is to evaluate utilization of health care services, hospitalization and spine surgery. A total of 20 patients with chronic (> 6 months) discogenic low back pain who received intradiscal injection of either PRP or BMC were followed in this study with data on pain (Verbal Pain Scale, VPS) and function (SF-36) collected at 1, 3, 6, 12, and 18 months post-injection. Additional assessments included utilization of medications, health care services, hospitalization, and spine surgery. Of the 20 patients, 18 remained at 6 months and 15 remained at 18 months. Of those who remained, more than 50% relief in VPS was noted in 94% of patients at 6 months, and in 93% of patients at 18 months. An improvement in SF-36s physical component summary (PCS) was noted in 100% of patients at 6 months, and in 93% of patients at 18 months. There were no reported side effects or adverse reactions noted from the injections. Medication use decreased in 89% of patients at 6 months and in 80% of patients at 18 months. None of the patients presented to the emergency room, were hospitalized, or underwent surgery for the spinal area treated with the injection. This study supports the safety of a single intradiscal biologic injection and provides additional evidence for its efficacy in management of lumbar discogenic pain, with improvements in both pain and function, and decreased utilization of medications and medical services thereby decreasing health care costs. Key words: Autologous, biologics, platelet-rich plasma, bone marrow concentrate, injections, lumbar, disc, discogenic pain, regenerative medicine