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

Autor:	Bise, Sylvain, Dallaudiere, Benjamin, Pesquer, Lionel, Pedram, Morad, Meyer, Philippe, Antoun, Myriame Bou, Hocquelet, Arnaud, Silvestre, Alain
Předmět:	EPIDURAL injections PLATELET-rich plasma LUMBAR pain CHRONIC pain GROWTH factors INJECTIONS RADICULAR cyst PAIN management RESEARCH STEROIDS RESEARCH methodology EVALUATION research MEDICAL cooperation RADICULOPATHY TREATMENT effectiveness COMPARATIVE studies COMPUTED tomography LONGITUDINAL method DISEASE complications
Zdroj:	European Radiology; Jun2020, Vol. 30 Issue 6, p3152-3160, 9p, 1 Black and White Photograph, 1 Diagram, 1 Chart, 1 Graph
Abstrakt:	Introduction: 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).Methods: 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.Results: 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.Conclusion: The results of CT-guided interlaminar EPRPI are similar to ESI for the treatment of persistent LRP and could be a safer option.Key Points: • 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. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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