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Pain and Spine Medicine

Session: Processing Methods and Treatment Outcomes of Platelet-Rich Plasma Therapy for Chronic Discogenic Low Back Pain: a Systematic Review and Meta-analysis

Processing Methods and Treatment Outcomes of Platelet-Rich Plasma Therapy for Chronic Discogenic Low Back Pain: A Systematic Review and Meta-analysis

Friday, October 24, 2025
12:00 PM - 1:30 PM MT
Location: Original Research Theater
Disclosure(s):
Antonio Madrazo Ibarra, MD: No financial relationships to disclose
Daniel De La Huerta Meza, MD: No financial relationships to disclose
Background and/or Objectives: The number of randomized controlled trials using platelet-rich plasma (PRP) to treat chronic discogenic low back pain (LBP) has drastically increased during the last couple of years. However, the preparation methodology of PRP used in these studies has not been extensively studied.

Design: Systematic review and meta-analysis of randomized controlled trials (RCT)

Setting : Outpatient clinic

Participants : Adult patients with chronic discogenic LBP enrolled in RCTs comparing PRP injections to control interventions.

Interventions: Epidural or intradiscal PRP injection versus control (epidural or intradiscal corticosteroids or placebo).

Main Outcome Measures: The primary outcome of this systematic review is to describe the PRP preparation methods used in RCTs evaluating PRP for the treatment of chronic discogenic LBP. Secondary outcomes include comparing PRP to control interventions in terms of pain relief, functional improvement, and adverse events.

Results: Eleven studies (638 patients) were included in this systematic review and meta-analysis. 6 studies reported performing intradiscal injections, and 5 studies epidural injections. 5 studies used placebo as the control group and 6 studies used corticosteroids as the control group. Information on PRP preparation and composition was limited and heterogeneous. Complete information about the methodology to prepare PRP allowing replication was reported in only 1 (9%) study. Complete platelet yield and leukocyte counts were reported in 2 (18%) studies. No significant differences were found in pain and functional improvement between PRP and control groups at any time point. High heterogeneity was observed across all outcomes. Two serious adverse events were reported only following PRP treatment.

Conclusions: PRP preparation methods and composition are inadequately reported in RCTs evaluating PRP for chronic discogenic LBP. There are no significant differences between PRP and control groups for pain relief and functional improvement. Future rigorous RCTs with standardized PRP protocols are needed to improve reporting quality and enable meaningful outcome comparisons.