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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Efficacy of intradiscal autologous platelet-rich plasma injection in chronic lumbar disc prolapse: A quasi-experimental study
Prabu Mounisamy, Anirudh Dwajan, Dibyajyoti Sahoo, Naveen Jeyaraman, Sathish Muthu, Swaminathan Ramasubramanian, Madhan Jeyaraman
Prabu Mounisamy, Anirudh Dwajan, Department of Orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, Pondicherry, India
Dibyajyoti Sahoo, Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, Pondicherry, India
Naveen Jeyaraman, Madhan Jeyaraman, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600077, Tamil Nadu, India
Naveen Jeyaraman, Sathish Muthu, Madhan Jeyaraman, Department of Orthopaedics, Orthopaedic Research Group, Coimbatore 641045, Tamil Nadu, India
Naveen Jeyaraman, Swaminathan Ramasubramanian, Madhan Jeyaraman, Department of Regenerative Medicine, Agathisha Institute of Stemcell and Regenerative Medicine (AISRM), Chennai 600030, Tamil Nadu, India
Sathish Muthu, Central Research Laboratory, Meenakshi Medical College Hospital and Research Institute, Meenakshi Academy of Higher Education and Research, Kanchipuram 631552, Tamil Nadu, India
Author contributions: Mounisamy P, Dwajan A, and Sahoo D contributed to conceptualization; Mounisamy P, Jeyaraman M, and Sahoo D contributed to acquiring clinical data and performing the data analysis; Dwajan A, Jeyaraman N, and Ramasubramanian S contributed to manuscript writing; Mounisamy P, Jeyaraman M, and Ramasubramanian S helped in manuscript revision; Muthu S contributed for image acquisition; Jeyaraman M contributed to proofreading; Jeyaraman M and Mounisamy P contributed to administration; all authors have agreed to the final version to be published and agree to be accountable for all aspects of the work.
Institutional review board statement: The study was conducted in Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), a tertiary care center in Puducherry, India between July 2022 and June 2024 after approval from the JIPMER Institutional Ethics Committee with approval document JIP/IEC/2022/072 dated 10 October, 2022.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: There are no data available for sharing.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Madhan Jeyaraman, MD, PhD, Researcher, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Vela
ppanchavadi, Chennai 600077, Tamil Nadu, India.
madhanjeyaraman@gmail.com
Received: June 10, 2025
Revised: July 9, 2025
Accepted: October 20, 2025
Published online: December 18, 2025
Processing time: 192 Days and 0.4 Hours
BACKGROUND
Low back pain is a major cause of disability worldwide, with intervertebral disc degeneration contributing to nearly 40% of cases. Conventional treatments focus on symptom relief without addressing the underlying degeneration. Platelet-rich plasma (PRP), a regenerative therapy rich in growth factors, offers potential therapeutic benefits through growth factor-mediated mechanisms, though clinical evidence is limited.
AIM
To evaluate the efficacy of intradiscal autologous PRP injection in reducing pain and improving function in patients with chronic lumbar disc prolapse.
METHODS
This pilot quasi-experimental study was conducted in tertiary care centre between July 2022 and June 2024. The study involved comparing the outcomes between group A (n = 17) who failed to respond to conservative treatment measures and received intradiscal PRP injection with group B (n = 22) who responded to conservative treatment. Visual Analogue Scale (VAS) and Functional Rating Index (FRI) scores were recorded at baseline, 3 weeks, and 6 weeks for both the groups.
RESULTS
Forty patients were enrolled in the study. The PRP group demonstrated significant improvement in VAS and FRI scores compared to baseline. While both groups improved from their respective baselines, direct between-group comparisons are limited by baseline differences in symptom severity. Patients who failed conservative trial showed significant improvement following PRP intervention, with outcomes approaching those observed in physiotherapy responders.
CONCLUSION
Intradiscal PRP injection significantly improved pain and function in patients with lumbar disc disease, with clinical improvements that approached the level observed in physiotherapy responders, despite baseline differences in symptom severity. PRP shows promise as an effective treatment for lumbar disc pathology; however, these preliminary findings are limited by the small sample size and short follow-up, warranting larger trials with long-term evaluation.
Core Tip: Intradiscal autologous platelet-rich plasma injection significantly reduced pain and improved function in chronic lumbar disc prolapse patients unresponsive to physiotherapy, achieving outcomes comparable to physiotherapy responders at 3 and 6 weeks. While these preliminary findings are encouraging, the brief 6-week follow-up period precludes assessment of durability, and larger studies with extended follow-up are essential to establish long-term efficacy, evaluate potential structural effects and safety.
