PMID- 29177632
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200929
IS  - 2197-1153 (Print)
IS  - 2197-1153 (Electronic)
IS  - 2197-1153 (Linking)
VI  - 4
IP  - 1
DP  - 2017 Nov 25
TI  - The use of lumbar epidural injection of platelet lysate for treatment of 
      radicular pain.
PG  - 38
LID - 10.1186/s40634-017-0113-5 [doi]
LID - 38
AB  - BACKGROUND: Epidural steroid injections (ESI) are the most common pain management 
      procedure performed in the US, however evidence of efficacy is limited. In 
      addition, there is early evidence that the high dose of corticosteroids used can 
      have systemic side effects. We describe the results of a case series evaluating 
      the use of platelet lysate (PL) epidural injections for the treatment of lumbar 
      radicular pain as an alternative to corticosteroids. METHODS: Registry data was 
      obtained for patients (N = 470) treated with PL epidural injections presenting 
      with symptoms of lumbar radicular pain and MRI findings that were consistent with 
      symptoms. Collected outcomes included numeric pain score (NPS), functional rating 
      index (FRI), and a modified single assessment numeric evaluation (SANE) rating. 
      RESULTS: Patients treated with PL epidurals reported significantly lower 
      (p < .0001) NPS and FRI change scores at all time points compared to baseline. 
      Post-treatment FRI change score means exceeded the minimal clinically important 
      difference beyond 1 month. Average modified SANE ratings showed 49.7% improvement 
      at 24 months post-treatment. Twenty-nine (6.3%) patients reported mild adverse 
      events related to treatment. CONCLUSION: Patients treated with PL epidurals 
      reported significant improvements in pain, exceeded the minimal clinically 
      important difference (MCID) for FRI, and reported subjective improvement through 
      2-year follow-up. PL may be a promising substitute for corticosteroid.
FAU - Centeno, Christopher
AU  - Centeno C
AD  - Centeno-Schultz Clinic, Broomfield, CO, 80021, USA.
AD  - Regenexx, LLC, Des Moines, IA, 50321, USA.
FAU - Markle, Jason
AU  - Markle J
AD  - Centeno-Schultz Clinic, Broomfield, CO, 80021, USA.
FAU - Dodson, Ehren
AU  - Dodson E
AUID- ORCID: 0000-0002-5808-6068
AD  - Centeno-Schultz Clinic, Broomfield, CO, 80021, USA. edodson@regenexx.com.
AD  - Regenexx, LLC, Des Moines, IA, 50321, USA. edodson@regenexx.com.
FAU - Stemper, Ian
AU  - Stemper I
AD  - Regenexx, LLC, Des Moines, IA, 50321, USA.
FAU - Hyzy, Matthew
AU  - Hyzy M
AD  - Centeno-Schultz Clinic, Broomfield, CO, 80021, USA.
FAU - Williams, Christopher
AU  - Williams C
AD  - Centeno-Schultz Clinic, Broomfield, CO, 80021, USA.
FAU - Freeman, Michael
AU  - Freeman M
AD  - CAPHRI School of Public Health and Primary Care, Maastricht University, 
      Maastricht, Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20171125
PL  - United States
TA  - J Exp Orthop
JT  - Journal of experimental orthopaedics
JID - 101653750
PMC - PMC5701904
OTO - NOTNLM
OT  - Back pain
OT  - Corticosteroids
OT  - Lumbar
OT  - Platelet lysate
OT  - Radicular
OT  - Regenerative
OT  - Spine
OT  - Steroids
COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Patients provided verbal and written 
      consent. The International Cellular Medicine Society provided IRB oversight and 
      approval (OHRP Registration #IRB00002637). Trial registration number: 
      NCT03011398; A Clinical Registry of Orthobiologics Procedures. CONSENT FOR 
      PUBLICATION: All patients provided consent for publication. COMPETING INTERESTS: 
      CC is a shareholder and CMO of Regenexx, LLC and president and owner of the 
      Centeno-Schultz Clinic. JM, ED, IS, CW, MH and MF have declared no competing 
      interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to 
      jurisdictional claims in published maps and institutional affiliations.
EDAT- 2017/11/28 06:00
MHDA- 2017/11/28 06:01
PMCR- 2017/11/25
CRDT- 2017/11/28 06:00
PHST- 2017/08/23 00:00 [received]
PHST- 2017/10/25 00:00 [accepted]
PHST- 2017/11/28 06:00 [entrez]
PHST- 2017/11/28 06:00 [pubmed]
PHST- 2017/11/28 06:01 [medline]
PHST- 2017/11/25 00:00 [pmc-release]
AID - 10.1186/s40634-017-0113-5 [pii]
AID - 113 [pii]
AID - 10.1186/s40634-017-0113-5 [doi]
PST - epublish
SO  - J Exp Orthop. 2017 Nov 25;4(1):38. doi: 10.1186/s40634-017-0113-5.