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<p>Discogenic low back pain (DLBP) is a major cause of disability. Platelet-rich plasma (PRP) has shown regenerative potential in preclinical models, but clinical results remain heterogeneous and early biological responses in humans are incompletely understood. We conducted a prospective cohort study (November 2023–October 2024) to evaluate early clinical outcomes and quantitative MRI (qMRI) changes after intradiscal PRP injection for DLBP. Symptom scores (VAS, ODI and FRI) and qMRI measures (whole-disc T2 and vertebral marrow fat fraction in adjacent vertebrae) were assessed at baseline and at 1, 3 and 6 months. A composite minimal clinically important difference (MCID) was predefined as a ≥ 30% reduction from baseline in both VAS and ODI. Longitudinal changes were analyzed using linear mixed-effects models, and baseline-to-6-month changes were correlated using Pearson tests. Forty-five patients were recruited and 29 completed follow-up. VAS, ODI and FRI decreased significantly over time (all <i>P</i> &lt; 0.001), and 79.3% achieved the composite MCID at 6 months. Vertebral marrow fat fraction adjacent to the treated disc declined significantly (<i>P</i> &lt; 0.001) and correlated with improvements in VAS, ODI and FRI (<i>r</i> ≈ 0.46–0.56; <i>P</i> &lt; 0.01), whereas changes in whole-disc T2 were small and not associated with symptom change. No treatment-related complications were observed. Intradiscal PRP appeared safe and clinically promising over 6 months, with qMRI suggesting an early effect on the peridiscal metabolic environment.</p>

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Intradiscal platelet-rich plasma for discogenic low back pain: a prospective cohort study of early clinical outcomes and quantitative MRI findings

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月24日

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  • Xiaohan Pan,
  • Gang Peng,
  • Qi Yao,
  • Zeyu Liu,
  • Xiaojun Zhang,
  • Wei Jiang,
  • Jie Hao

摘要

Discogenic low back pain (DLBP) is a major cause of disability. Platelet-rich plasma (PRP) has shown regenerative potential in preclinical models, but clinical results remain heterogeneous and early biological responses in humans are incompletely understood. We conducted a prospective cohort study (November 2023–October 2024) to evaluate early clinical outcomes and quantitative MRI (qMRI) changes after intradiscal PRP injection for DLBP. Symptom scores (VAS, ODI and FRI) and qMRI measures (whole-disc T2 and vertebral marrow fat fraction in adjacent vertebrae) were assessed at baseline and at 1, 3 and 6 months. A composite minimal clinically important difference (MCID) was predefined as a ≥ 30% reduction from baseline in both VAS and ODI. Longitudinal changes were analyzed using linear mixed-effects models, and baseline-to-6-month changes were correlated using Pearson tests. Forty-five patients were recruited and 29 completed follow-up. VAS, ODI and FRI decreased significantly over time (all P < 0.001), and 79.3% achieved the composite MCID at 6 months. Vertebral marrow fat fraction adjacent to the treated disc declined significantly (P < 0.001) and correlated with improvements in VAS, ODI and FRI (r ≈ 0.46–0.56; P < 0.01), whereas changes in whole-disc T2 were small and not associated with symptom change. No treatment-related complications were observed. Intradiscal PRP appeared safe and clinically promising over 6 months, with qMRI suggesting an early effect on the peridiscal metabolic environment.