PRP for Spinal Diseases: Comprehensive Systematic Review
Defined by PMC review · International Journal of Molecular Sciences (PMC) (2023)
This comprehensive systematic review assessed PRP applications across all spinal diseases, categorizing evidence for intradiscal therapy, facet joint injection, sacroiliac joint injection, epidural injection, and spinal fusion augmentation. The strongest evidence supported intradiscal PRP for degenerative disc disease (Level III, fair evidence).
Clinical Relevance
The most complete overview of PRP in spine applications. Clinicians should note that evidence quality varies dramatically by application site within the spine. Intradiscal and facet/SIJ injections show the most promise.
Key Takeaways
- Intradiscal PRP: Level III (fair) evidence for degenerative disc disease
- Facet joint PRP: Level IV (limited) evidence, safe and useful
- SIJ PRP: Level IV (limited) evidence, safe and useful
- Spinal fusion PRP: limited/unclear benefit
- Epidural PRP: emerging, inconclusive
- LP-PRP strongly recommended for intradiscal (avascular disc environment)
- PRP classification by Mishra system improves comparability
Key Findings
Intradiscal PRP: safe and effective (fair evidence, Level III). Facet/SIJ injection: safe and useful but limited evidence (Level IV). Spinal fusion augmentation: limited/unclear benefit. Epidural PRP: emerging evidence, inconclusive. LP-PRP recommended for intradiscal due to avascular environment.
Clinical Context
Study Design
Systematic Review
Condition
Degenerative Disc Disease, Facet Joint, SIJ, Epidural, Spinal Fusion
Control Group
Steroids, Saline, Sham (various)
Primary Outcome
VAS, ODI, SF-12/36
PRP Protocol & Intervention
Preparation System
Various (classified by Mishra system)
Leukocyte Status
Variable (LP-PRP recommended for intradiscal)
Guidance Method
Fluoroscopy or CT-guided