“HEALING PATHWAYS IN LUMBAR DISC PROLAPSE: A PROSPECTIVE FUNCTIONAL COMPARISON BETWEEN EPIDURAL PRP AND STEROID INFILTRATION”

Abstract

Background: Lumbar disc prolapse is a prevalent cause of low back pain, particularly in adults under 45, often leading to disability and reduced quality of life. Among the many treatment options, epidural steroid injections (ESIs) have long been a standard non-surgical approach. Recently, platelet-rich plasma (PRP) therapy has emerged as a regenerative alternative with promising outcomes.

Objective: This prospective observational study aimed to compare the clinical effectiveness of epidural PRP versus steroid injections in patients diagnosed with lumbar disc prolapse, focusing on pain reduction and functional improvement.

Methods: Sixty patients with MRI-confirmed intervertebral disc prolapse were divided into two equal groups (n=30 each). Group S received interlaminar epidural steroid injections, while Group P received PRP prepared by double centrifugation. Pain and function were assessed using VAS, MODQ, NRS, and SLRT at baseline, 1, 3, and 6 months post-procedure.

Results: Both groups demonstrated significant improvements in pain scores and functional outcomes over time. While the PRP group showed slightly better gains in SLRT and ODI at six months, the differences between groups were not statistically significant. No complications were reported in the PRP group, whereas one patient in the steroid group experienced transient giddiness.

Conclusion: Both epidural PRP and steroid injections are effective in managing pain and improving function in lumbar disc prolapse. PRP offers a comparable, safe, and biologically regenerative alternative to steroids, especially in patients with comorbidities where steroids are contraindicated.