■创伤后枕大神经痛(GON)的治疗包括连续注射类固醇/麻醉剂。虽然这些注射可以减轻疼痛,影响可以是短暂的,经常只持续1个月。作为一种潜在的选择,富血小板血浆(PRP)注射是一种新兴的生物学治疗方法,对周围神经疾病具有有益作用。我们调查了可行性,安全,与生理盐水或类固醇/麻醉剂注射相比,单次注射PRP治疗创伤后GON的有效性。
■在这个随机试验中,双盲,安慰剂对照试验,32名患有创伤后GON的成年人被分配为1:1:1,接受(1)自体PRP(2)类固醇/麻醉剂或(3)生理盐水的单次超声引导注射。我们的主要结果是可行性(招募,出席,保留)和安全性(不良事件)。探索性措施包括头痛强度和频率(每日头痛日记)和其他问卷(头痛影响,和生活质量)在注射前评估,1周,1个月,注射后3个月。
■我们筛选了67个人,55%的人符合条件,95%的人参加。超过80%的每日头痛日记完成了91%的参与者完成了3个月的结果问卷。未报告严重不良事件。两组之间的头痛强度或频率没有显着差异。在PRP中,头痛对功能测试-6评分的影响在3个月时有所改善(β=-9.7,95%CI[-15.6,-3.74],p=0.002)和生理盐水(β=-6.7[-12.7,-0.57],p=0.033)组,而不是类固醇/麻醉组(p=0.135)。
■PRP是治疗创伤后GON的可行且安全的方法,其结果与盐水和类固醇/麻醉剂相当。需要更大样本量的进一步试验。临床试验注册:https://clinicaltrials.gov/,标识符NCT04051203。
UNASSIGNED: Treatment for post-traumatic greater occipital neuralgia (GON) includes serial injections of steroid/anesthetic. While these injections can alleviate pain, effects can be transient, frequently lasting only 1 month. As a potential alternative, platelet-rich plasma (PRP) injections are an emerging biological treatment with beneficial effects in peripheral nerve disorders. We investigated the feasibility, safety, and effectiveness of a single PRP injection for post-traumatic GON in comparison to saline or steroid/anesthetic injection.
UNASSIGNED: In this pilot randomized, double-blinded, placebo-controlled trial, 32 adults with post-traumatic GON were allocated 1:1:1 to receive a single ultrasound-guided injection of (1) autologous PRP (2) steroid/anesthetic or (3) normal saline. Our primary outcome was feasibility (recruitment, attendance, retention) and safety (adverse events). Exploratory measures included headache intensity and frequency (daily headache diaries) and additional questionnaires (headache impact, and quality of life) assessed at pre-injection, 1 week, 1 month, and 3 months post-injection.
UNASSIGNED: We screened 67 individuals, 55% were eligible and 95% of those participated. Over 80% of daily headache diaries were completed with 91% of participants completing the 3-month outcome questionnaires. No serious adverse events were reported. There were no significant differences between groups for headache intensity or frequency. Headache impact on function test-6 scores improved at 3 month in the PRP (β = -9.7, 95% CI [-15.6, -3.74], p = 0.002) and saline (β = -6.7 [-12.7, -0.57], p = 0.033) groups but not steroid/anesthetic group (p = 0.135).
UNASSIGNED: PRP is a feasible and safe method for treating post-traumatic GON with comparable results to saline and steroid/anaesthetic. Further trials with larger sample sizes are required.Clinical trial registration:https://clinicaltrials.gov/, identifier NCT04051203.