Effects of pain relief of platelet-rich plasma caudal epidural injection in lumbar spinal stenosis

Le Viet Thang, Bui Hoang Tuan Dung

Main Article Content

Abstract

Caudal epidural injection is a common interventional method for the treatment of sciatica symptoms in patients with single-level lumbar spinal stenosis. In this case series, we evaluated the analgesic efficacy of platelet-rich plasma in patients with single-level lumbar spinal stenosis. The study included 57 patients with single-level lumbar spinal stenosis and was performed at the Pain Management Unit, University Medical Center at Ho Chi Minh City from January 2025 to June 2025. The results showed significant improvements in the Numeric Rating Scale (NRS) and Oswestry Disability Index (ODI) scores after 1 week, 1 month, and 3 months compared to baseline (p < 0.001). Caudal epidural injection is a safe and effective method for the treatment of lumbar spinal stenosis with good short-term results. Ultrasound-guided platelet-rich plasma injection was effective in pain relief and functional improvement.

Article Details

References

1. Lee BH, Moon SH, Suk KS, Kim HS, Yang JH, Lee HM. Lumbar Spinal Stenosis: Pathophysiology and Treatment Principle: A Narrative Review. Asian Spine J. 2020 Oct; 14(5): 682-693. doi: 10.31616/asj.2020.0472. Epub 2020 Oct 14. PMID: 33108834; PMCID: PMC7595829.
2. Deer T, Sayed D, Michels J, Josephson Y, Li S, Calodney AK. A Review of Lumbar Spinal Stenosis with Intermittent Neurogenic Claudication: Disease and Diagnosis. Pain Med. 2019 Dec 1; 20(Suppl 2): S32-S44. doi: 10.1093/pm/pnz161. PMID: 31808530; PMCID: PMC7101166.
3. Fornari M, Robertson SC, Pereira P, Zileli M, Anania CD, Ferreira A, Ferrari S, Gatti R, Costa F. Conservative Treatment and Percutaneous Pain Relief Techniques in Patients with Lumbar Spinal Stenosis: WFNS Spine Committee Recommendations. World Neurosurg X. 2020 Jun 23; 7:100079. doi: 10.1016/j.wnsx.2020.100079. PMID: 32613192; PMCID: PMC7322792.
4. Manchikanti L, Singh V, Pampati V, Falco FJ, Hirsch JA. Comparison of the efficacy of caudal, interlaminar, and transforaminal epidural injections in managing lumbar disc herniation: is one method superior to the other? Korean J Pain. 2015 Jan; 28(1): 11-21. doi: 10.3344/kjp.2015.28.1.11. Epub 2015 Jan 2. PMID: 25589942; PMCID: PMC4293502.
5. Park KD, Kim TK, Lee WY, Ahn J, Koh SH, Park Y. Ultrasound-Guided Versus Fluoroscopy-Guided Caudal Epidural Steroid Injection for the Treatment of Unilateral Lower Lumbar Radicular Pain: Case-Controlled, Retrospective, Comparative Study. Medicine (Baltimore). 2015 Dec; 94(50): e2261. doi: 10.1097/MD.0000000000002261. PMID: 26683948; PMCID: PMC5058920.
6. Verheijen EJA, Bonke CA, Amorij EMJ, Vleggeert-Lankamp CLA. Epidural steroid compared to placebo injection in sciatica: a systematic review and meta-analysis. Eur Spine J. 2021 Nov; 30(11): 3255-3264. doi: 10.1007/s00586-021-06854-9. Epub 2021 May 11. PMID: 33974132.
9. Machado ES, Soares FP, Vianna de Abreu E, de Souza TADC, Meves R, Grohs H, Ambach MA, Navani A, de Castro RB, Pozza DH, Caldas JMP. Systematic Review of Platelet-Rich Plasma for Low Back Pain. Biomedicines. 2023 Aug 28; 11(9): 2404. doi: 10.3390/biomedicines11092404. PMID: 37760845; PMCID: PMC10525951.
10. Wang H, Zhu J, Xia Y, Li Y, Fu C. Application of platelet-rich plasma in spinal surgery. Front Endocrinol (Lausanne). 2023 Mar 15; 14: 1138255. doi: 10.3389/fendo.2023.1138255. PMID: 37008931; PMCID: PMC10057539.
11. Bise S, Dallaudiere B, Pesquer L, Pedram M, Meyer P, Antoun MB, Hocquelet A, Silvestre A. Comparison of interlaminar CT-guided epidural platelet-rich plasma versus steroid injection in patients with lumbar radicular pain. Eur Radiol. 2020 Jun; 30(6): 3152-3160. doi: 10.1007/s00330-020-06733-9. Epub 2020 Feb 24. PMID: 32095875.
12. Ruiz-Lopez R, Tsai YC. A Randomized Double-Blind Controlled Pilot Study Comparing Leucocyte-Rich Platelet-Rich Plasma and Corticosteroid in Caudal Epidural Injection for Complex Chronic Degenerative Spinal Pain. Pain Pract. 2020 Jul;20(6):639-646. doi: 10.1111/papr.12893. Epub 2020 May 6. PMID: 32255266.