Regenerative Injection Treatments Utilizing Platelet Products and Prolotherapy for Cervical Spine Pain: A Functional Spinal Unit Approach.

Ehren Dodson,Chaz Fausel,Christopher Williams,Ian Stemper,Christopher Centeno,Mairin Jerome

doi:10.7759/cureus.18608

Abstract

BackgroundThe increasing burden of musculoskeletal disorders combined with the high utilization of opiates and the relatively limited ability of traditional approaches to satisfactorily address many of these conditions has spurred an increased interest in alternative treatments such as regenerative medicine therapies. Evidence is growing to support the use of regenerative injection treatments, including prolotherapy, platelet-rich plasma (PRP), platelet lysate (PL), and mesenchymal stromal cells. This study aims to offer a proof of concept via a case series of patients with neck pain treated using a functional spinal unit (FSU) model with combination prolotherapy, PRP, and PL injections.MethodologyA chart review identified patients with neck pain treated with a combination of cervical injections using concentrated platelets and prolotherapy.ResultsA total of 14 patients met the inclusion criteria. The average decrease in the Numeric Pain Score was 2.8 (p = 0.002). The mean decrease in the Functional Rating Index was 27.3 (p = 0.004) at 24 months. Two patients had mild adverse reactions.ConclusionsThis case series demonstrates basic safety and clinically significant improvements in patients treated for neck pain with autologous concentrated platelet products and prolotherapy utilizing an FSU treatment protocol. Additional clinical studies are warranted with a larger patient sample size and longer follow-up periods.

Highlights

As people are living longer, musculoskeletal pathology has become the leading cause of disability worldwide, with back pain accountable as the leading driver of years lived with disability [1]
Two patients had mild adverse reactions. This case series demonstrates basic safety and clinically significant improvements in patients treated for neck pain with autologous concentrated platelet products and prolotherapy utilizing an functional spinal unit (FSU) treatment protocol
Additional clinical studies are warranted with a larger patient sample size and longer follow-up periods

Summary

Introduction

As people are living longer, musculoskeletal pathology has become the leading cause of disability worldwide, with back pain accountable as the leading driver of years lived with disability [1]. Though low back pain is the leading contributor to the number of years lived with disability, a review of global disease burden from 1990 to 2013 found neck pain to be the fourth most common cause of years lived with disability globally and second to low back pain for high-income countries [1]. The increasing burden of musculoskeletal disorders combined with the high utilization of opiates and the relatively limited ability of traditional approaches to satisfactorily address many of these conditions has spurred an increased interest in alternative treatments such as regenerative medicine therapies. This study aims to offer a proof of concept via a case series of patients with neck pain treated using a functional spinal unit (FSU) model with combination prolotherapy, PRP, and PL injections

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