Intradiscal Platelet Rich Plasma (PRP)

What is an intradiscal PRP injection and how can it help?

Injection of platelet rich plasma (PRP) is still considered an experimental treatment, although evidence for its effects are mounting. PRP can induce inflammation and healing in the tissue in which it is injected, and has beneficial effects in treating other painful conditions. Recent studies have shown there to be evidence that PRP may be beneficial in patients with degenerative disc disease. With the assumption that inflammation and degeneration are the cause of disc related pain, we inject a small amount of PRP into the nucleus pulposus of the intervertebral disc.

Approximately 40% of low back pain is thought to come from the intervertebral disc disease. As we age, or through trauma and accidents, the discs become damaged. As they become damaged, and through tears in their outer layers, they lose their functional integrity and hydration, leading to the in growth of pain sensing nerves. This is often referred to as discogenic pain.

Intradiscal PRP is a procedure in which we use platelet-rich plasma in hopes of healing the disc tissue.  If your physician feels that your back pain may be stemming from the intervertebral disc, you may be a candidate to try PRP.

Read on to learn more about PRP and the injection of PRP into the disc.

What is PRP?

PRP is blood plasma that has been enriched with platelets. As a concentrated source of autologous platelets (your own blood), PRP contains several different growth factors and other cytokines that can stimulate healing of bone and soft tissue. Platelet rich plasma therapy utilizes growth factors present in alpha granules of platelets. Platelet-rich plasma therapy is an old therapy and used extensively in specialties of dermatology, orthopedics, and dentistry. Main indications in dermatology for PRP are androgenetic alopecia, wound healing, and facial rejuvenation.

prpAlthough blood is mainly a liquid (called plasma), it also contains small solid components (red cells, white cells, and platelets.) The platelets are best known for their importance in clotting blood. However, platelets also contain hundreds of proteins called growth factors which are very important in the healing of injuries. PRP is plasma with many more platelets than what is typically found in blood. The concentration of platelets — and, thereby, the concentration of growth factors — can be 5 to 10 times.

PRP injection is a procedure in which we use your own blood to treat a painful condition.  A small amount of blood is drawn and then placed in a centrifuge for processing.  Much of the plasma and red blood cells are removed to obtain a high concentration of platelets which hold the growth factors used to promote healing.  We then inject your own platelet-rich plasma back into the specific area causing your pain.  Studies have shown that PRP releases a high concentration of growth factors and even stimulates stem cells which help to heal injured or degenerated tissues.

The intradiscal PRP procedure itself

Prior to the procedure, you will be brought into the procedure room and blood will be drawn in strict sterile fashion. This blood is then processed thought the centrifuge and the PRP is extracted.

prp2You can request oral or IV sedation before the spinal injection portion of the procedure. Under fluoroscopic (live x-ray) guidance, a needle is placed into the disc or discs that are felt to be causing your pain. The PRP previously prepared from your own blood is then injected into the disc.  All of this is performed in our office.  Although the spinal procedure itself takes just a couple minutes, the entire process can take over an hour.

Would intradiscal PRP help me?

We would first have to determine if you were even a candidate for intradiscal treatment. This determination is made from your clinical history, physical exam, imaging, and other diagnostic tests.  Research has shown that PRP is likely helpful for conditions in other areas of the body with similar structural make up as intervertebral discs.  Studies of PRP on disc tissue have demonstrated the healing properties.  An ongoing trial of PRP for patients with discogenic low back pain has shown promising preliminary results.  However, we will not know the extent of its benefit without further studies.  The doctors at The Spine & Pain Institute of New York are conducting a study to help evaluate this exciting treatment option.  Before considering participating in this study, you should be aware of all the risks and potential benefits as well as any alternative treatment options for your condition.  Our research physicians and staff will be happy to discuss these with you.