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- Title
Comparison of interlaminar CT-guided epidural platelet-rich plasma versus steroid injection in patients with lumbar radicular pain.
- Authors
Bise, Sylvain; Dallaudiere, Benjamin; Pesquer, Lionel; Pedram, Morad; Meyer, Philippe; Antoun, Myriame Bou; Hocquelet, Arnaud; Silvestre, Alain
- Abstract
<bold>Introduction: </bold>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).<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusion: </bold>The results of CT-guided interlaminar EPRPI are similar to ESI for the treatment of persistent LRP and could be a safer option.<bold>Key Points: </bold>• 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.
- Subjects
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
- Publication
European Radiology, 2020, Vol 30, Issue 6, p3152
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-020-06733-9