The purpose of the study was to evaluate the clinical efficacy of platelet–rich plasma for functional recovery in patients with vertebral neurological pathology. The study was carried out in the clinical department of the State Institution “Ukrainian Research Institute of Medical Rehabilitation and Balneology of the Ministry of Health of Ukraine” during 2016–2018. Material and methods. 115 patients with manifestations of widespread osteochondrosis of the spine with a primary lesion of the cervical and lumbosacral spine were examined. Patients were divided into two groups: the main (n = 85) group of patients who used platelet–rich plasma treatment and the control (n = 30) group with standard treatment with non–steroidal anti–inflammatory drugs (diclofenac 75 mg per day, injection route). The average age of patients included in the control group was 35.6±0.9 years. There were 18 (60.0 %) women and 12 (40.0 %) men in this group. There were younger patients in the main group. Their age was 20–45 years (n = 29, average age 33.4±1.1 years), a single administration of platelet–rich plasma was performed. Patients over the age of 45 years (n=56, average age 52.2±0.8 years) underwent repeated administration of platelet–rich plasma with an interval of 7–10 days between treatments. By gender composition, the main group was similar to the control one (there were 46women (54.1 %), and 39 men (45.9 %), p> 0.05). Results and discussion. In the group of patients treated with non–steroidal anti–inflammatory drugs after 3 days of observation, the pain decreased by 1.2±0.2 points on the visual–analog scale, and in the group for the use of platelet–rich plasma therapy, the pain intensity decreased by 0.6±0.1 point compared to baseline level. After 2 weeks of treatment, there was a significant decrease in the severity of pain according to the visual–analog scale in the control group by 2.1±0.2 points (p <0.05), and in the main group by 1.6±0.2 points (p <0.05). The results of a three–month observation of patients showed that the use of platelet–rich plasma therapy contributed to a decrease in pain according to the visual–analog scale to 2.0±0.2 points, which was on average 4 points less than the initial level (p <0.05). The described changes were accompanied by the increase in the spine mobility, as well as in the shoulder joints. These changes were more pronounced in patients treated with platelet–rich plasma. Shoulder abduction during the use of platelet–rich plasma increased from 78.6±4.3 to 160.3±9.5 in patients younger than 45 years and to 130.5±3.9 in older patients. The arm lift forward improved from 45.5±3.1 to 145.4±7.8 and 127.3±3.8, respectively. Conclusion. The obtained data illustrated the improvement in the performance of functional tests of the spine on the background of anti–inflammatory therapy, and in the group of patients who received platelet–rich plasma therapy, more stable positive dynamics were demonstrated. This allows us to recommend platelet–rich plasma therapy for widespread use in patients with vertebral neurological pathology.
Keywords: back pain, vertebral neurological pathology, functional recovery, treatment
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