Clinical Observation For The Treatment Of Lumbar Facet Joint Syndrome Using Accurate Intra-articular Injection With Autologous Platelet Rich Plasma

Objective:By observing the clinical efficacy of intra-articular injection with autologous platelet rich plasma for the treatment of lumbar facet joint syndrome,to seek a safer and more effective new method for the interventional therapy of lumbar facet joint syndrome.Materials and Methods:119 patients with potential lumbar facet joint syndrome in outpatient department of spine surgery of the Second Hospital of Jilin University from Jan.2015 to Aug.2016 were enrolled in our study.After further strict screening,the remaining 48 patients were assigned randomly into experimental group(24 patients)and control group(24 patients).Experimental group patients were administered with intra-articular injection with autologous PRP under fluoroscopy;Control group patients were administered with intra-articular injection with a mixture of local anesthetic and corticosteroid under fluoroscopy.During a 6-month follow-up,we compared the differences of pain visual analogue scale(VAS)under different states,pain remission rate,Roland-Morris Disability Questionnaire(RMQ),Oswestry Disability Index(ODI),modified Mac Nab criteria and related complications before and after the treatment.In addition,the comparisons between the two groups were carried out.Results:1.General information: There was no significant difference between the two groups ih these information at baseline including gender,age,BMI,courses and characteristics of disease.2.Visual analogue scale(VAS): Whether at rest or during flexion,compared with pre-treatment,both experimental group and control group demonstrated statistical improvements in low back pain after 1 week(P<0.05).In the short-term period(1 week & 1 month),the pain relief in control group was significantly better than experimental group(P<0.05).3.Lumbar functional capacity(RMQ and ODI): Compared with pre-treatment,Significant improvement in lumbar functional capacity was observed in both two groups.However,control group was better in the short-term period,and experimental group was better in the long-term period.4.Subjective satisfaction(modified Mac Nab criteria): In the short-term period,control group was better and showed the highest excellent rate of 83.33% at 1month after the treatment.However,experimental group was better in the long-term period with the highest excellent rate of 75.00% at 6 months after the treatment.5.Safety: There were no severe treatment-related complications such as infection,rejection and nerve injury happened in both groups.For two groups,the aggravation of low back pain occurred easily immediately after treatment,but was rare in other follow-up points.Conclusions:1.Accurate intra-articular injection under fluoroscopy is a safe and effective therapeutic method to treat lumbar facet joint syndrome.2.In the short-term period,local anesthetic and corticosteroid is better.However,autologous PRP also has an effect on lumbar facet joint syndrome.3.In the medium-and-long-term period,autologous PRP is more effective than local anesthetic and corticosteroid and seems to be a superior treatment option.