Implementation of Platelet-Rich Plasma in Regeneration of Spinal Nerve Affected by Symptomatic Disc Herniation

Abstract

Degenerative disc disease (DDD) is characterized by autoimmune inflammation and, in some cases, the development of peripheral paresis, sensory impairment, as well as severe pain due to axonal damage of spinal nerve or root because of compression by a disc herniation. In such cases, conservative treatment is not effective. Delaying surgical intervention can lead to irreversible impairment of nerve function. In some cases, patients refuse surgery and will become disabled for the rest of their lives. Here, in our practice, two patients with peripheral monoparesis, sensory disturbances and leg pain due to a disc herniation in VL4-L5 and VL5-S1 segments were saved from surgical intervention after retrodiscal, epidural and infraneural injection of platelet-rich plasma (PRP), even though there was an indication for surgery. Conservative treatment was ineffective in both patients. Although patients, who are candidates for surgery, always undergo surgical intervention, in our case because of PRP injection in proper places, patients were saved from operation. This compels neurosurgeons and physicians, who treat patients traditionally, to think deeply before referring patients to the operation room and increases our knowledge in the treatment plane. There was a decrease in the inflammatory process and recovery of the nerve function over a short period, as well as regression of the symptoms of the disease because of PRP. Hence, injecting PRP into a proper place in complicated herniated disc disease can stimulate nerve regeneration and decrease an inflammation process that can prevent surgical intervention.