Biologics for Lumbar Discogenic Pain: 18 Month Follow-up for Safety and Efficacy

The primary objective of this paper is to evaluatesafety and effectiveness of platelet rich plasma(PRP) and bone marrow concentrate (BMC)injections in the lumbar intervertebral disc. Thesecondary objective is to evaluate utilization ofhealth care services, hospitalization and spinesurgery. A total of 20 patients with chronic (> 6months) discogenic low back pain who receivedintradiscal injection of either PRP or BMC werefollowed in this study with data on pain (VerbalPain Scale, VPS) and function (SF-36) collectedat 1, 3, 6, 12, and 18 months post-injection. Additionalassessments included utilization of medications,health care services, hospitalization, andspine surgery. Of the 20 patients, 18 remainedat 6 months and 15 remained at 18 months. Ofthose who remained, more than 50% relief in VPSwas noted in 94% of patients at 6 months, and in93% of patients at 18 months. An improvementin SF-36s physical component summary (PCS)was noted in 100% of patients at 6 months, andin 93% of patients at 18 months. There were noreported side effects or adverse reactions notedfrom the injections. Medication use decreased in89% of patients at 6 months and in 80% of patientsat 18 months. None of the patients presented tothe emergency room, were hospitalized, or underwentsurgery for the spinal area treated withthe injection. This study supports the safety of asingle intradiscal biologic injection and providesadditional evidence for its efficacy in managementof lumbar discogenic pain, with improvements inboth pain and function, and decreased utilizationof medications and medical services thereby decreasinghealth care costs.Key words: Autologous, biologics, platelet-richplasma, bone marrow concentrate, injections, lumbar,disc, discogenic pain, regenerative medicine