The Effectiveness and Safety of Percutaneous Platelet-Rich Plasma and Bone Marrow Aspirate Concentrate for the Treatment of Suspected Discogenic Low Back Pain: a Comprehensive Review

Purpose of ReviewComprehensively review the effectiveness and safety of percutaneous, fluoroscopically guided, intradiscal injection of platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) for the treatment of suspected discogenic low back pain.Recent FindingsPublications in PubMed up to February 2019 were independently assessed. The literature search yielded three intradiscal PRP studies: one randomized controlled trial and two prospective cohort studies. Five intradiscal BMAC studies were identified. Four of the five prospective cohort studies were completed by the same primary author and results pertained to the same treatment group at different follow-up time points. A single case series of treatment with intradiscal BMAC was identified.SummaryThe evidence for use of percutaneous, fluoroscopy-guided, intradiscal PRP or BMAC for the treatment of suspected discogenic low back pain appears safe, potentially positive, but is limited due to low-quality studies, natural history of discogenic pain, and variable reporting characteristics. Further quality research is needed.