PDF(Pubmed)
Abstract：
Low back pain (LBP) and neck pain predominate as the primary causes of disability. Cell- and platelet-rich plasma (PRP) products are potential therapies with clinical trials and reviews promoting their efficacy. Nonetheless, they frequently disregard the clinical significance of reported improvements. In this systematic review, the effectuated improvements in pain, disability, quality of life (QoL), and radiographic images are comprehensively described and scored on their clinical significance. An electronic database literature search was conducted on July 2023 for in-human assessment of cell or PRP products to alleviate discogenic pain. Papers were screened on quantitative pain, disability, QoL, radiographic improvements, and safety outcomes. Risk of bias was assessed through MINORS and Cochrane Source of Bias tools. Reported outcomes were obtained, calculated, and assessed to meet minimal clinically important difference (MCID) standards. From 7623 screened papers, a total of 80 articles met the eligibility criteria, presenting 68 specific studies. These presented at least 1974 treated patients. Overall, cell/PRP injections could alleviate pain and disability, resulting in MCID for pain and disability in up to a 2-year follow-up, similar to those observed in patients undergoing spinal fusion. Included trials predominantly presented high levels of bias, involved heterogeneous study designs, and only a minimal number of randomized controlled trials. Nonetheless, a clear clinically significant impact was observed for cell- and PRP-treated cohorts with overall good safety profiles. These results highlight a strong therapeutic potential but also underline the need for future cost-effectiveness assessments to determine the benefits of cell/PRP treatments.
摘要：
下腰痛（LBP）和颈部疼痛是导致残疾的主要原因。富含细胞和血小板的血浆（PRP）产品是潜在的治疗方法，其临床试验和评价可提高其疗效。尽管如此，他们经常忽视报告的改善的临床意义.在这次系统审查中，疼痛的有效改善，残疾,生活质量（QoL），和射线照相图像进行全面描述并对其临床意义进行评分。2023年7月进行了电子数据库文献检索，以在人体内评估细胞或PRP产品以减轻椎间盘源性疼痛。论文进行了定量疼痛筛查，残疾,QoL,射线照相改进，和安全结果。通过MINORS和Cochrane偏差源工具评估偏差风险。获得了报告的结果，calculated,并评估符合最小临床重要差异（MCID）标准。从7623篇筛选论文中，共有80篇文章符合资格标准，提出68项具体研究。这些提供了至少1974名接受治疗的患者。总的来说,细胞/PRP注射可以减轻疼痛和残疾，在长达2年的随访中导致疼痛和残疾的MCID，与接受脊柱融合术的患者相似。纳入的试验主要呈现高水平的偏见，涉及异质研究设计，只有最少数量的随机对照试验。尽管如此，对于总体安全性良好的细胞和PRP治疗的队列,观察到明显的临床显著影响.这些结果突出了强大的治疗潜力，但也强调了未来成本效益评估以确定细胞/PRP治疗的益处的必要性。
