Disclosures: Mairin A. Jerome, MD: No financial relationships or conflicts of interest

Objective: To evaluate pain and function improvements in patients identified by registry data with cervical pain who were treated by targeting the osteoligamentous complex known as the functional spinal unit (FSU) using platelet-based injections. We hypothesized that treatment of the entire FSU is an effective treatment paradigm for axial neck pain with or without radiculopathy.

Design: This study is a retrospective chart review from registry data, including longitudinal patient-reported outcomes. Setting : All procedures were performed at a single, outpatient interventional pain and musculoskeletal clinic. Participants : Adult males and females with axial neck pain with or without radiculopathy.

Interventions: Flouroscopically-guided cervical epidural, cervical facet joint, and cervical ligament injections with levels treated determined by patient history, physical examination, and imaging studies. Injectates included concentrated platelets, platelet lysate, and hypertonic dextrose solution.

Main Outcome Measures: The main outcome measures included safety, pain, and function. Safety data was evaluated through adverse event reporting. Pain and functional outcome measures were obtained to 24 months post-injection and included numeric pain scale (NPS), functional rating index (FRI), and modified single assessment numeric evaluation (SANE).

Results: Fourteen patients who underwent spine procedures and were enrolled in the registry met inclusion criteria. Outcomes data for included patients showed an average decrease in NPS of 2.8 (p=0.002; CI: [-4.5, -1.5]) and a mean decrease in FRI of 27.3 (p=0.004; CI: [-33.8, -10.4]) from baseline to 24 months. Average reported percentage improvement in symptoms (modified SANE) was 64% at 24-months, with a peak average improvement of 71% at 12 months. Two patients had mild, self-resolving adverse reactions. Conclusions: This case series demonstrates basic safety as well as clinically significant improvements in pain and functional outcomes in patients treated for neck pain with autologous concentrated platelets under an FSU evaluation and treatment protocol.

Level of Evidence: Level IV

« Back to AAPM&R Annual Assembly 2020

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/utilizing-platelet-based-treatments-for-cervical-spine-pain-via-a-functional-spinal-unit-paradigm-a-case-series/