Effectiveness of Intradiscal Regenerative Medicine Therapies for Long-Term Relief of Chronic Low Back Pain: A Systematic Review and Meta-Analysis.

作者：Laxmaiah Manchikanti, Emilija Knezevic, Nebojša Nick Knežević, Alan D. Kaye, Sairam Atluri, Mahendra Sanapati, Vidyasagar Pampati, Joshua A Hirsch · 发表于：PubMed · 年份：2024 · 被引用次数：7 · 研究领域：Spine and Intervertebral Disc Pathology、Periodontal Regeneration and Treatments、Tendon Structure and Treatment

BACKGROUND: Recent research underscores the potential of intradiscal biologics, such as mesenchymal stem cells (MSCs), platelet-rich plasma (PRP), and alpha-2-macroglobulin, in promoting chondrogenesis within lumbar intervertebral discs as a treatment for discogenic low back pain. Studies indicate significant improvements in pain relief, physical function, and overall quality of life following these interventions. OBJECTIVE: This study aims to evaluate the effectiveness of intradiscal injections of MSCs and PRP in managing low back and lower extremity pain. A systematic review and meta-analysis were conducted to assess the outcomes of these treatments. STUDY DESIGN: A systematic review and meta-analysis evaluating the efficacy of PRP and MSC injections for discogenic low back and lower extremity pain. DATA SOURCES: The review included literature from PubMed, Cochrane Library, the U.S. National Guideline Clearinghouse (NGC), prior systematic reviews, and reference lists, covering studies from 1966 to September 2024. STUDY SELECTION: Randomized controlled trials (RCTs), observational studies, and case reports focusing on biologic injections into the disc were included. DATA EXTRACTION AND SYNTHESIS: Data were extracted and assessed for methodological quality. Evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria and summarized based on best evidence synthesis principles on a 1-to-5 scale. RESULTS: The analysis inclu...