Tratamiento con láser más plasma rico en plaquetas para dolor crónico discogénico lumbar por hernia discal

  1. Luis Miguel Torres Morera 1
  2. José Manuel Trinidad 2
  3. Diego Benítez 2
  4. Ramón Eizaga 2
  5. Enrique Calderón 2
  1. 1 Universidad de Cádiz
    info

    Universidad de Cádiz

    Cádiz, España

    ROR https://ror.org/04mxxkb11

  2. 2 Hospital Puerta del Mar, Cádiz
Journal:
MPJ Multidisciplinary Pain Journal

ISSN: 2697-2263

Year of publication: 2023

Issue: 1

Type: Article

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More publications in: MPJ Multidisciplinary Pain Journal

Abstract

Introduction: Degenerative disc disease (DDD) is a major cause of low back pain. Laser treatment (Percutaneus laser disc decompression or PLDD) of the intervertebral disc (IVD) produces enhanced decompression and remodeling when combined with the regenerative reaction produced by platelet-rich plasma (PRP) administered at the same time. Method: Open, unicentric and non-comparative study, of real clinical practice. 41 patients with lumbar disc disease, clinically diagnosed and evidenced by Magnetic Resonance Imaging (MRI) with radiating neuropathic pain coinciding with the pathological disc, were treated: with Laser (Neolaser®). At the end of the application of energy through the laser, 5 ml of PRP extracted previously were infiltrated intradiscally. The needle was inserted on the side of the protrusion, with the patient in prone position, under X-ray control (PA and L). When the needle was being removed from the foraminal foramen, 1 ml of triamcinolone (40 mg) and 2 ml of bupivacaine 0.5 % were administered. All procedures were performed in the operating room, under strict asepsis, local anesthesia, and prophylactic treatment with antibiotics. Results: 41 patients (28 men and 13 women) have been treated. Pain was measured using a visual analogue scale (VAS). The VAS was baseline was 7.1 ± 0.5; at 2 months 2.7 ± 0.6 (p = 0.000); at 6 months 2 ± 0.7 (p = 0.000) and at 12 months 2.9 ± 0.8 (p = 0.000). Functionality was measured with the Oswestry Disability Index (ODI). The baseline ODI was 52.30 ± 9.4; at 2 months 32.07 ± 5.1 (p = 0.100) 29 ± 5.5; at 6 months (p = 0.016) and 2 3.1 ± 8.7 at 12 months (p = 0.000). 13 % of patients had back pain after the intervention for approximately one month, during the intervention 21 % had neuropathic pain, 2 % arterial hypotension, 3 % tachycardia and 0.4 % nauseas. 9 % were surgically intervened in the year after treatment, no patient had discitis, infection, or bleeding at the puncture site. Conclusion: The treatment of herniated disc with laser + PRP, is a new, safe, effective, and feasible treatment modality. We have shown it to be an effective therapy for the treatment of discogenic pain due to lumbar disc herniation, offering new and interesting perspectives for the treatment of herniated vertebral disc.

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Data source: Dialnet