A Prospective Study Comparing Platelet-Rich Plasma and Local Anesthetic (LA)/ Corticosteroid in Intra-Articular Injection for the Treatment of Lumbar Facet Joint Syndrome

Abstract

Key Words: low back pain, lumbar facet joint syndrome, intra-articular injection, platelet-rich plasma, LA/corticos- teroid

INTRODUCTION
Lumbar facet joint syndrome has been defined as a kind of low back pain with or without referred pain to the buttock, groin, or proximal thigh deriving from lumbar.

Objectives: To compare the effectiveness and safety between autologous platelet-rich plasma (PRP) and local anesthetic (LA) or corticosteroid intra-articular injection for the treatment of lumbar facet joint syndrome.

Methods: Forty-six eligible patients with lumbar facet joint syndrome were randomized into groups A (intra-articular injection with PRP) and B (intra-articular injection with [A] or corticosteroid). The following contents were evaluated: pain on the visual analog scale (VAS) at rest and during flexion, and the Roland-Morris Disability Questionnaire (RMQ), the Oswestry Disability Index (ODI), and modified MacNab criteria for pain relief and applications of post-treatment drugs. All outcome assessments were performed immediately after and at 1 week, 1, 2, 3, and 6 months after treatment.

Address correspondence and reprint requests to: Qinyi Liu, MD, PhD, Department of Orthopedics, The Second Hospital, Jilin University,No. 218 Zigiang Street, Nanguan District, Changchun, Jilin 130041, China E-mail: 1226527208@qg.com.
J.W. and J.Z. contributed equally to this work.

Submitted: June 28,2016; Revised September 21, 2016;

Revision accepted: October 26, 2016 DOI. 10.1111/papr. 12544
©2016 WorldInstitute ofPain, 1530-7085/17/S15.00 Pain Practice, Volume 17, Issue 7, 2017 914-924

Results: No significant difference between groups was observed at baseline. Compared with pretreatment, both group A and group B demonstrated statistical improvements in the pain VAS score at rest or during flexion, the RMQ, and the ODI (P  0.01). And there were significant differences between the 2 groups on the above-mentioned items (P 0.05). For group B, subjective satisfaction based on the modified MacNab criteria and objective success rate were highest (80% and 85%) after 1 month, but only 50% and 20% after 6 months. However, for group A, they increased over time. In addition, there were no treatment-related complications in either group during follow-up.

Conclusions: Both autologous P-R and LA/corticosteroid for intra-articular injection are effective, easy, and safe enough in the treatment of lumbar facet joint syndrome. However, autologous PRP is a superior treatment option for longer-lasting efficacy.

Jiuping Wu, MSc*; Jingjing Zhou, MSc*; Chibing Liu, MSc*; Jun Zhang, MSc*; Wei Xiong, MSc*; Yang Lv, MSc*; Rui Liu, MSc*; Ruiqiang Wang, MSc*; Zhenwu Du, MD, PhD*; Guizhen Zhang, MD, PhD*; Qinyi Liu, MD, PhD*

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