PRP in Stubborn to treat lower back pain
Dr Gregory Lutz in 2011 initiated a study that was a double blind randomized controlled trial. It was conducted at the Hospital for Special Surgery. The study was to see if the platelet rich plasma (PRP) therapy was able to treat the patient with a long term chronic low back pain. The pain in such cases were caused by torn intervertebral discs. He thus becomes the pioneer in treating the low back pain by using PRP.
The participants of the study was a cohort of stubborn group where these patients have tried all the conventional, standard non-surgical treatment. They were facing the prospect of going for spinal fusion operation. The surgery being the last option they have.
The cohort who was given the PRP treatment, some 60 % shows significant improvements in pain and restoration of function. Some even got cured. Some patients were showing 100 % improvement. It is really a cure if the tear can heal.
He make another finding that the PRP therapy result is better for the 2-discs torn injury instead of just 1-disc injury. This result is the direct opposite of spinal fusion operation procedure for 1-disc injury. Why this unusual finding? It probably speaks of the power of PRP therapy as according to him.
This is the first time a study is carried out to see the effect of PRP treatment for the spine. For all this while, doctors have been unsure if PRP is strong enough for the spine treatment. They always think and focus on the use of stem cell instead. The study has clearly shown otherwise. He hopes that more trails can be carried out and replicated his result such that more evidences can be made known to the researching community.
The platelet initiate the healing process. It do so by clotting together at the injury site. At this target site it initiate the pulling of the stem cell to migrate to the injured area to create new tissue through proliferation and remodeling, so called the three stages of wound or collagen repair.
The spine has a very limited blood supply. So when the spine is injured, there may not be enough platelet to reach the injury site so as to initiate the healing response. In the older patient even less platelet ever reach the injury site of the spine. So with this, there may not be adequate platelet to jump-start the healing process. This is unless our doctor intervene to implant the magic prp into the intervetebral discs, and artificially jump-start the healing process.
When PRP is injected and delivered directly into the center of the gelatinous intervertebral disc, it will flow naturally into the torn site and the tissue surrounding the fibrous capsule at the torn site. In this manner, the body repair and regeneration will focus at the right target area.
The body just harness patient’s own innate ability for healing. Dr Lutz has done more than 200 PRP treatment. It is very safe and he don’t has any complication for the PRP therapy.
PRP had started since 1970s. It is the professional athletes like the Tiger Woods who has brought it into the media limelight. Hence, it draw more popular attention of the public to the magic power of prp by helping them to heal faster so that they can get back to play soonest possible.
Dr Lutz got his inspiration from the horse. His came across his college whose horse was injured and was given PRP injection. He was amazed to find the horse recover very fast and soon started galloping again. The success in treating torn tendon impressed him. He reasoned that since the tendon fiber is made up of collagen fiber, the spinal tissue of disc capsule is also make of collagen and therefore must response similarly.
After given some local anesthetic, the PRP is injected directly into the disc gelatinous material. Maximum result is seen from 6 to 12 weeks. At which time another treatment procedure can be given. However, for the majority they only requires a single treatment.
The small risk and big prospect
With a small fraction of the cost of surgery and the risk, it is really worth a try for prp therapy to exchange for a better quality of life. The time has really come where once it was thought that it is never possible to treat, can now be treated more safely and effectively.