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Background <p>Platelet-rich plasma (PRP) is increasingly used in orthopedic and spine surgery for its regenerative and anti-inflammatory effects, yet its clinical efficacy as an adjunct to percutaneous endoscopic lumbar discectomy (PELD) remains uncertain.</p> Methods <p>A systematic search was performed in PubMed, Scopus, Cochrane Library, and Google Scholar through September 2025. Five comparative studies involving 479 patients met the inclusion criteria. Extracted outcomes included postoperative pain (VAS for low back and leg pain), functional recovery (ODI and JOA scores), MRI-based structural measurements obtained both preoperatively and postoperatively (Pfirrmann grading, intervertebral disc height, and spinal canal cross-sectional area), as well as recurrence rates.</p> Results <p>PRP demonstrated significant benefits in early postoperative pain control, with lower VAS scores for low back pain (<i>p</i> &lt; 0.001) and leg pain (<i>p</i> &lt; 0.001) at 3&#xa0;months. Improvements in low back pain persisted at 6&#xa0;months (<i>p</i> = 0.003), while leg pain became borderline and no longer statistically significant (<i>p</i> = 0.05). Functional recovery also favored PRP, with higher clinician-assessed JOA scores at 3 and 6&#xa0;months (<i>p</i> = 0.02 and <i>p</i> &lt; 0.001) and improved patient-reported ODI scores at both time points (<i>p</i> &lt; 0.001). MRI-based outcomes indicated greater postoperative spinal canal expansion (<i>p</i> &lt; 0.001), better preservation of intervertebral disc height (<i>p</i> = 0.002), and less progression in Pfirrmann degenerative grading (<i>p</i> &lt; 0.001). PRP was additionally associated with a significantly reduced rate of recurrent lumbar disc herniation (<i>p</i> = 0.007).</p> Conclusions <p>PRP appears to enhance both clinical and structural outcomes when used as an adjunct to PELD, contributing to improved pain relief, functional recovery, and postoperative disc integrity. While promising, these findings highlight the need for larger high-quality studies to refine PRP protocols and confirm long-term effectiveness.</p>

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Percutaneous Endoscopic Lumbar Discectomy With or Without Platelet-Rich Plasma: A Meta-Analysis

  • 期刊论文

  • 发表日期：

    2026年5月19日

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  • Guy Awad,
  • Marc Boutros,
  • Jean-Pierre Saad,
  • Zina Smadi,
  • Jad Bou Monsef

摘要

Background

Platelet-rich plasma (PRP) is increasingly used in orthopedic and spine surgery for its regenerative and anti-inflammatory effects, yet its clinical efficacy as an adjunct to percutaneous endoscopic lumbar discectomy (PELD) remains uncertain.

Methods

A systematic search was performed in PubMed, Scopus, Cochrane Library, and Google Scholar through September 2025. Five comparative studies involving 479 patients met the inclusion criteria. Extracted outcomes included postoperative pain (VAS for low back and leg pain), functional recovery (ODI and JOA scores), MRI-based structural measurements obtained both preoperatively and postoperatively (Pfirrmann grading, intervertebral disc height, and spinal canal cross-sectional area), as well as recurrence rates.

Results

PRP demonstrated significant benefits in early postoperative pain control, with lower VAS scores for low back pain (p < 0.001) and leg pain (p < 0.001) at 3 months. Improvements in low back pain persisted at 6 months (p = 0.003), while leg pain became borderline and no longer statistically significant (p = 0.05). Functional recovery also favored PRP, with higher clinician-assessed JOA scores at 3 and 6 months (p = 0.02 and p < 0.001) and improved patient-reported ODI scores at both time points (p < 0.001). MRI-based outcomes indicated greater postoperative spinal canal expansion (p < 0.001), better preservation of intervertebral disc height (p = 0.002), and less progression in Pfirrmann degenerative grading (p < 0.001). PRP was additionally associated with a significantly reduced rate of recurrent lumbar disc herniation (p = 0.007).

Conclusions

PRP appears to enhance both clinical and structural outcomes when used as an adjunct to PELD, contributing to improved pain relief, functional recovery, and postoperative disc integrity. While promising, these findings highlight the need for larger high-quality studies to refine PRP protocols and confirm long-term effectiveness.