Transforaminal Injections of Platelet-Rich Plasma Compared with Steroid in Lumbar radiculopathy: A Prospective, Double-Blind Randomized Study

Amit Saraf; Altaf Hussain; Angad Singh Sandhu; Sandeep Bishnoi; Vaneet Arora

doi:10.1007/s43465-023-00898-3

Transforaminal Injections of Platelet-Rich Plasma Compared with Steroid in Lumbar radiculopathy: A Prospective, Double-Blind Randomized Study

Indian J Orthop. 2023 May 5;57(7):1126-1133. doi: 10.1007/s43465-023-00898-3. eCollection 2023 Jul.

Authors

Amit Saraf¹, Altaf Hussain¹, Angad Singh Sandhu¹, Sandeep Bishnoi¹, Vaneet Arora¹

Affiliation

¹ Department of Orthopaedics, Teerthanker Mahaveer Medical College and Research Centre, Delhi Road, 4th Floor, Hospital Building, NH 24, Bagadpur, Moradabad, Uttar Pradesh 244001 India.

Abstract

Purpose: To evaluate and compare the clinical efficacy of transforaminal steroid and platelet-rich plasma (PRP) injections in patients with discogenic lumbar radiculopathy.

Methods: 60 patients were randomized to be treated with single transforaminal injection of PRP (n = 29) or steroid (methylprednisolone acetate [n = 31]). Clinical assessment was done with Visual analogue scale (VAS), modified Oswestry low back pain disability index (MODI), and straight leg raise test (SLRT). Baseline assessment of outcomes was done followed by post-intervention evaluation at 1, 3, and 6 months. Both groups had similar baseline characteristics.

Results: There was a significant statistical improvement of VAS and MODI in both groups at follow-up (P < 0.05). In PRP group, minimal clinically important change (> 2 cm difference of mean for VAS and > 10-point change in MODI) for both outcome scores was achieved at all follow-up intervals (1, 3, 6 months), while as in steroid group, it was seen only at 1 and 3 months for both VAS and MODI. On intergroup comparison, better results were seen in steroid group at 1 month (P < 0.001 for both VAS and MODI), and in PRP group at 6 months (P < 0.001 for both VAS and MODI) with non-significant difference at 3 months (P = 0.605 for MODI and P = 0.612 for VAS). More than 90% tested SLRT negative in PRP group and 62% in steroid group at 6 months. No serious complications were seen.

Conclusion: Transforaminal injections of PRP and steroid improve short-term (up to 3 months) clinical outcome scores in discogenic lumbar radiculopathy, but clinically meaningful improvements sustaining for 6 months were provided by PRP only.

Keywords: Lumbar radiculopathy; Methylprednisolone acetate; Modified Oswestry low back pain disability index (MODI); Platelet-rich plasma (PRP); Visual analogue scale (VAS).

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