One of the more common and traditional methods for treating pain that shoots down a leg or arm (lumbar or cervical radiculopathy) due to a herniated disc or narrowing along a spinal nerve (spinal stenosis) is the use of steroid injections into the epidural space.

Many patients benefit from this treatment and find great relief from “epidural steroid” injections. Particularly, when medications, physical therapy, and other conservative measures fail to provide pain relief and improve functioning. In addition, many patients are able to avoid more invasive surgeries thanks to the anesthetic and anti-inflammatory effects of the medications in these injections.

However, these injections do not always work. And for those individuals that do not find relief or have a contraindication to the use of steroids (severe osteoporosis for example) alternatives have been lacking.

A recent study demonstrated that a new technology may have emerged called “Platelet Lysate.” Platelet Lysate simply means concentrated and broken up platelets.

Platelets are cells that exist within our whole blood. These cells have healing and wound clotting properties, and are rich with anti-inflammatory enzymes and growth factors. You may have heard of Platelet Rich Plasma or PRP. PRP is a essentially the purification and concentration of platelets from whole blood.

To obtain Platelet Lysate. PRP is frozen and then thawed. The process of thawing the platelets breaks the platelet cells and liberates the enzymes and growth factors. The residual cellular debris of the platelets can then be removed and the pure platelet enzymes “Platelet Lysate,” can then be injected into the epidural space. This is a clear alternative to the more traditional epidural steroid injection.

The benefit of Injecting Epidural Platelet Lysate over PRP may be several fold. PRP Injections due to their high content of inflammatory cells can be painful. Platelets also have the potential to adhere and cluster. Lysated platelets however are potentially more anti-inflammatory and offer the possibility of less local cellular aggregation.

The results of these epidural platelet lysate injections were reported in the Journal of Experimental Orthopedics. 470 patients with leg pain were treated with Platelet Lysate epidural injections by 20 different physicians in 13 clinics nation wide. Just under 50% of the patients treated reported improvement in pain and function at 24 months after the injection. No major complications were reported as a result of these injections.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701904/#!po=13.2184

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