Platelet-rich plasma injection versus surgical fixation procedure in management of spondylolisthesis grade 1

Abstract

ObjectivesTo compare the efficacy of three ultrasound-guided platelet-rich plasma (PRP) injections into the facet-joint capsule to the surgical procedure in patients with grade-1 degenerative spondylolisthesis, over a 1-year follow-up period, and to assess their effects on chronic low-back-pain alleviation and functional improvement.BackgroundSpondylolisthesis is a serious medical condition commonly treated surgically or with lumbar epidural steroids to relieve pain. Patients who continue to have considerable symptoms while receiving conservative treatment options may consider surgery.Patients and methodsA prospective clinical study was conducted on 100 patients with grade-1 degenerative spondylolisthesis. Patients were randomized into two equal groups. In group 1, 50 patients had three PRP injections into the facet-joint capsule using ultrasound guidance, while group 2 consisted of 50 individuals who had surgical procedure. They were evaluated using primary and secondary outcome measures, including the visual analog scale, Persian functional rating index, Oswestry disability index for low back pain, and Roland–Morris questionnaire.ResultsBoth groups of patients revealed improvement in their scores of evaluation tools regarding pain and function that was sustained up to 9 months of the study period in the PRP-injected group and up to 12 months in the second group who went to surgery.ConclusionsPRP is a safe and efficient treatment option for managing chronic low back pain in degenerative spondylolisthesis grade-1 patients; it can be used as a less-invasive treatment strategy besides medical and physical modalities, especially in patients who are unfit or refusing surgery.