Is platelet-rich plasma better than steroids as epidural drug of choice in lumbar disc disease with radiculopathy? Meta-analysis of randomized controlled trials
The current meta-analysis was performed to analyze the efficacy and safety of platelet-rich plasma (PRP) as an epidural injectate, in comparison with steroids in the management of radiculopathy due to lumbar disc disease (LDD). We conducted independent and duplicate searches of the electronic databa...
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Frontiers Media S.A.
2025-02-01
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| Series: | Experimental Biology and Medicine |
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| Online Access: | https://www.ebm-journal.org/articles/10.3389/ebm.2025.10390/full |
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| author | Sathish Muthu Sathish Muthu Sathish Muthu Vibhu Krishnan Viswanathan Vibhu Krishnan Viswanathan Prakash Gangadaran Prakash Gangadaran Prakash Gangadaran |
| author_facet | Sathish Muthu Sathish Muthu Sathish Muthu Vibhu Krishnan Viswanathan Vibhu Krishnan Viswanathan Prakash Gangadaran Prakash Gangadaran Prakash Gangadaran |
| author_sort | Sathish Muthu |
| collection | DOAJ |
| description | The current meta-analysis was performed to analyze the efficacy and safety of platelet-rich plasma (PRP) as an epidural injectate, in comparison with steroids in the management of radiculopathy due to lumbar disc disease (LDD). We conducted independent and duplicate searches of the electronic databases (PubMed, Embase and Cochrane Library) in March 2024 to identify randomized controlled trials (RCTs) analyzing the efficacy of epidural PRP for pain relief in the management of LDD. Animal or in vitro studies, clinical studies without a comparator group, and retrospective or non-randomised clinical studies were excluded. Diverse post-intervention pain scores [visual analog score (VAS)] and functional scores [Oswestry Disability Index (ODI), SF-36], as reported in the reviewed studies, were evaluated. Statistical analysis was performed using STATA 17 software. 5 RCTs including 310 patients (PRP/Steroids = 153/157) were included in the analysis. The included studies compared the efficacy and safety of epidural PRP and steroids at various time-points including 1, 3, 6, 12, 24, and 48 weeks. Epidural PRP injection was found to offer comparable pain relief (VAS; WMD = −0.09, 95% CI [−0.66, 0.47], p = 0.641; I2 = 96.72%, p < 0.001), functional improvement (ODI; WMD = 0.72, 95% CI [-6.81, 8.25], p = 0.524; I2 = 98.73%, p < 0.001), and overall health improvement (SF-36; WMD = 1.01, 95% CI [−1.14, 3.17], p = 0.224; I2 = 0.0%, p = 0.36) as epidural steroid injection (ESI) at all the observed time points in the included studies without any increase in adverse events or complications. Epidural administration of PRP offers comparable benefit as epidural steroid injection (ESI) in the management of radiculopathy due to LDD. The safety profile of the epidural PRP is also similar to ESI. |
| format | Article |
| id | doaj-art-96d3fda3129b41cd8f37fc624f742051 |
| institution | Kabale University |
| issn | 1535-3699 |
| language | English |
| publishDate | 2025-02-01 |
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| series | Experimental Biology and Medicine |
| spelling | doaj-art-96d3fda3129b41cd8f37fc624f7420512025-02-04T04:11:12ZengFrontiers Media S.A.Experimental Biology and Medicine1535-36992025-02-0125010.3389/ebm.2025.1039010390Is platelet-rich plasma better than steroids as epidural drug of choice in lumbar disc disease with radiculopathy? Meta-analysis of randomized controlled trialsSathish Muthu0Sathish Muthu1Sathish Muthu2Vibhu Krishnan Viswanathan3Vibhu Krishnan Viswanathan4Prakash Gangadaran5Prakash Gangadaran6Prakash Gangadaran7Department of Spine Surgery, Orthopaedic Research Group, Coimbatore, IndiaDepartment of Biotechnology, Faculty of Engineering, Karpagam Academy of Higher Education, Coimbatore, IndiaDepartment of Orthopaedics, Government Medical College, Karur, IndiaDepartment of Spine Surgery, Orthopaedic Research Group, Coimbatore, IndiaDepartment of Orthopaedics, Devadoss Hospital, Madurai, IndiaDepartment of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of KoreaBK21 FOUR KNU Convergence Educational Program of Biomedical Sciences for Creative Future Talents, School of Medicine, Kyungpook National University, Daegu, Republic of KoreaCardiovascular Research Institute, Kyungpook National University, Daegu, Republic of KoreaThe current meta-analysis was performed to analyze the efficacy and safety of platelet-rich plasma (PRP) as an epidural injectate, in comparison with steroids in the management of radiculopathy due to lumbar disc disease (LDD). We conducted independent and duplicate searches of the electronic databases (PubMed, Embase and Cochrane Library) in March 2024 to identify randomized controlled trials (RCTs) analyzing the efficacy of epidural PRP for pain relief in the management of LDD. Animal or in vitro studies, clinical studies without a comparator group, and retrospective or non-randomised clinical studies were excluded. Diverse post-intervention pain scores [visual analog score (VAS)] and functional scores [Oswestry Disability Index (ODI), SF-36], as reported in the reviewed studies, were evaluated. Statistical analysis was performed using STATA 17 software. 5 RCTs including 310 patients (PRP/Steroids = 153/157) were included in the analysis. The included studies compared the efficacy and safety of epidural PRP and steroids at various time-points including 1, 3, 6, 12, 24, and 48 weeks. Epidural PRP injection was found to offer comparable pain relief (VAS; WMD = −0.09, 95% CI [−0.66, 0.47], p = 0.641; I2 = 96.72%, p < 0.001), functional improvement (ODI; WMD = 0.72, 95% CI [-6.81, 8.25], p = 0.524; I2 = 98.73%, p < 0.001), and overall health improvement (SF-36; WMD = 1.01, 95% CI [−1.14, 3.17], p = 0.224; I2 = 0.0%, p = 0.36) as epidural steroid injection (ESI) at all the observed time points in the included studies without any increase in adverse events or complications. Epidural administration of PRP offers comparable benefit as epidural steroid injection (ESI) in the management of radiculopathy due to LDD. The safety profile of the epidural PRP is also similar to ESI.https://www.ebm-journal.org/articles/10.3389/ebm.2025.10390/fullPRPepidural steroiddegenerative disc diseasepain reliefbiologics |
| spellingShingle | Sathish Muthu Sathish Muthu Sathish Muthu Vibhu Krishnan Viswanathan Vibhu Krishnan Viswanathan Prakash Gangadaran Prakash Gangadaran Prakash Gangadaran Is platelet-rich plasma better than steroids as epidural drug of choice in lumbar disc disease with radiculopathy? Meta-analysis of randomized controlled trials Experimental Biology and Medicine PRP epidural steroid degenerative disc disease pain relief biologics |
| title | Is platelet-rich plasma better than steroids as epidural drug of choice in lumbar disc disease with radiculopathy? Meta-analysis of randomized controlled trials |
| title_full | Is platelet-rich plasma better than steroids as epidural drug of choice in lumbar disc disease with radiculopathy? Meta-analysis of randomized controlled trials |
| title_fullStr | Is platelet-rich plasma better than steroids as epidural drug of choice in lumbar disc disease with radiculopathy? Meta-analysis of randomized controlled trials |
| title_full_unstemmed | Is platelet-rich plasma better than steroids as epidural drug of choice in lumbar disc disease with radiculopathy? Meta-analysis of randomized controlled trials |
| title_short | Is platelet-rich plasma better than steroids as epidural drug of choice in lumbar disc disease with radiculopathy? Meta-analysis of randomized controlled trials |
| title_sort | is platelet rich plasma better than steroids as epidural drug of choice in lumbar disc disease with radiculopathy meta analysis of randomized controlled trials |
| topic | PRP epidural steroid degenerative disc disease pain relief biologics |
| url | https://www.ebm-journal.org/articles/10.3389/ebm.2025.10390/full |
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