Efficacy of autologous platelet-rich plasma versus corticosteroid injections in degenerative facet joint syndrome
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20261217Keywords:
Degenerative facet joint syndrome, Platelet-rich plasma, Corticosteroid, Intra-articular injection, Low back painAbstract
Background: Degenerative Facet Joint Syndrome (DFJS) is a common cause of chronic low back pain, particularly in the elderly. Current treatments, including intra-articular corticosteroid (CS) injections, offer short-term relief but are associated with adverse effects. Autologous platelet-rich plasma (PRP) injections have emerged as a potential alternative due to their regenerative properties and minimal side effects. This study compares the efficacy of single intra-articular PRP versus CS injections in managing DFJS. To evaluate and compare the short- and long-term functional outcomes of intra-articular PRP and CS injections in patients with DFJS.
Methods: This prospective, randomized controlled trial included 74 patients diagnosed with DFJS, randomly divided into two groups. Group A (n=37) received a single intra-articular PRP injection, while Group B (n=37) received a single intra-articular CS injection. Outcomes were assessed using the Visual Analog Scale, Present Pain Index, Modified Oswestry Disability Index, Roland-Morris Questionnaire, and Short Form Health-12 at 4 weeks, 8 weeks, 12 weeks, 6 months, and 1-year post-injection.
Results: Both groups showed significant reductions in pain and disability scores. In the short term, the CS group demonstrated greater improvement, though not statistically significant. However, at 1 year, the PRP group showed superior outcomes in pain reduction, functional ability, and quality of life, with long-term benefits surpassing those of CS.
Conclusions: Intra-articular PRP injections offer a safe and effective treatment option for DFJS, providing longer-lasting relief compared to CS. While both treatments are beneficial, PRP may be the preferable choice for patients seeking sustained improvement in pain and functionality.
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References
Kotb SY, Sherif NM, Saleh HA, Ahmed SF, Sakr HM, Taeimah MO. The role of intra-articular injection of autologous platelet-rich plasma versus corticosteroids in the treatment of synovitis in lumbar facet joint disease. Saudi Med J. 2022;43(11):1200-8. DOI: https://doi.org/10.15537/smj.2022.43.11.20220449
Won HS, Yang M, Kim YD. Facet joint injections for management of low back pain: a clinically focused review. Anesth Pain Med. 2020;15(1):8-18. DOI: https://doi.org/10.17085/apm.2020.15.1.8
Mann SJ, Viswanath O, Singh P. Lumbar Facet Arthropathy. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2023. Available at: http://www.ncbi.nlm.nih.gov/books/NBK538228/. Accessed on 17 December 2025.
Su DCJ, Chang KV. Facet Arthritis. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2024. Available at: http://www. ncbi.nlm.nih.gov/books/NBK493233/. Accessed on 17 December 2025.
Monfett M, Harrison J, Boachie-Adjei K, Lutz G. Intradiscal platelet-rich plasma (PRP) injections for discogenic low back pain: an update. Int Orthop. 2016;40(6):1321-8.
Chang RG, Hurwitz NR, Harrison JR, C J, Lutz GE. Ankylosing Spondylitis Versus Internal Disc Disruption: A Case Report Treated Successfully with Intradiscal Platelet-Rich Plasma Injection. Spine Res. 2017;3(1). DOI: https://doi.org/10.21767/2471-8173.10004
Mohammed S, Yu J. Platelet-rich plasma injections: an emerging therapy for chronic discogenic low back pain. J Spine Surg. 2018;4(1):115-22. DOI: https://doi.org/10.21037/jss.2018.03.04
Filardo G, Previtali D, Napoli F, Candrian C, Zaffagnini S, Grassi A. PRP Injections for the Treatment of Knee Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials. Cartilage. 2021;13(1):364S-75. DOI: https://doi.org/10.1177/1947603520931170
IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp. 2015. Available at: https://www.ibm.com/products/spss-statistics?. Accessed on 17 December 2025.
Wu J, Du Z, Lv Y, Zhang J, Xiong W, Wang R, et al. A New Technique for the Treatment of Lumbar Facet Joint Syndrome Using Intra-articular Injection with Autologous Platelet Rich Plasma. Pain Physician. 2016;19(8):617-25. DOI: https://doi.org/10.36076/ppj/2016.19.617
Singh C, Yadav S, Loha S, Prakash S, Paswan AK. Comparison of intra-articular lumbar facet joint injection of platelet-rich plasma and steroid in the treatment of chronic low back pain: A prospective study. J Orthop Trauma Rehabil. 2023. DOI: https://doi.org/10.1177/22104917231161836
Navani A, Ambach M, Calodney A, Rosenthal R, Li G, Mahoney CB, et al. The Safety and Effectiveness of Orthobiologic Injections for Discogenic Chronic Low Back Pain: A Multicenter Prospective, Crossover, Randomized Controlled Trial with 12 Months Follow-up. Pain Physician. 2024;27(1):E65-77. DOI: https://doi.org/10.36076/ppj.2024.27.E65
Monfett M, Harrison J, Boachie-Adjei K, Lutz G. Intradiscal platelet-rich plasma (PRP) injections for discogenic low back pain: an update. Int Orthop. 2016;40(6):1321-8. DOI: https://doi.org/10.1007/s00264-016-3178-3
Patel A, Koushik S, Schwartz R, Gritsenko K, Farah F, Urits I, et al. Platelet-Rich Plasma in the Treatment of Facet Mediated Low Back Pain: A Comprehensive Review. Orthop Rev (Pavia). 2022;14(4):37076. DOI: https://doi.org/10.52965/001c.37076
Hellmich D, Kob A, Deubler R, Schröder C, Rose P, Elsäßer R. Acute Treatment of Facet Syndrome by CT-Guided Injection of Dexamethasone-21-Palmitate Alone and in Combination with Mepivacaine. Clin Drug Investig. 2004;24(10):559-67. DOI: https://doi.org/10.2165/00044011-200424100-00001
Kawabata S, Akeda K, Yamada J, Takegami N, Fujiwara T, Fujita N, et al. Advances in Platelet-Rich Plasma Treatment for Spinal Diseases: A Systematic Review. Int J Mol Sci. 2023;24(8):7677. DOI: https://doi.org/10.3390/ijms24087677