Platelet-rich Plasma Infiltration Versus Corticosteroid Infiltration (Prednisolone) in Treatment of Lumbar Facet Joint Syndrome

• Status: Not yet recruiting
• Trial end date: 2023-03-01
• Target enrollment: 0
• Participant gender: All

Summary

The prevalence of low back pain is estimated at 90% . Recent studies have shown that 15% to 52% of back pain is attributable to facet joint syndrome .

Being the only vertebral joints provided with a synovial membrane, the posterior inter-apophyseal joints are subject, like all other peripheral joints, to degenerative arthritis phenomena.

These phenomena most often result in the release of pro-inflammatory cytokines resulting in cartilage degradation.

PRP or platelet rich plasma is an autologous blood product obtained after centrifugation of a peripheral blood sample. The PRP has many anti-inflammatory properties. Numerous studies have shown the interest of intra-articular infiltration of PRP in osteoarthritis of the knee but also in tendinopathies of the shoulder and a few studies also suggest the use of PRP in the spine "intra-disc, epidural and posterior joints) .

Corticosteroid infiltrations in the posterior lumbar joints constituting the standard treatment in posterior inter-apophyseal osteoarthritis.

The goal is to obtain a new therapeutic weapon in the management of this frequent and invalid disease for patients who are often elderly and with other comorbidity.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: CHU de Reims
• Treatments: Prednisolone

Criteria

Inclusion Criteria:

• Patient seen at the University Hospital of Reims for an infiltration in the context of pain in low back pain attributable to posterior inter-apophyseal osteoarthritis

• Patient over 18 years old

• Patient presenting at least 5 criteria (and criteria 3) (Cochin criteria):

• Low back pain not exacerbated by cough

• Lumbalgia well relieved by the decubitus

• Low back pain not exacerbated when leaning forward

• Low back pain not exacerbated when getting up

• Low back pain not exacerbated in hyper extension

• Low back pain not exacerbated in Extension - Rotation

• Patient with an MRI dating less than 1 year before inclusion: No herniated disc in the level of the posterior joints to be infiltrated (example: if an infiltration of the post L4-L5 joint is planned, it is considered that there must be no herniated disc at the level L4-L5)

• Patient having signed the consent

• Patient affiliated to a social security scheme

Exclusion Criteria:

• Contraindications to corticosteroid infiltrations: unbalanced hypertension, unbalanced diabetes, allergy, skin condition next to the infiltration site, not compatible with an infiltration

• Patient who received corticosteroid infiltration within the last 6 months

• Patient who has already received an injection of PRP (for the spine or another indication).

• History of previous spine surgery

• Presence of an ongoing local or systemic infection

• Coagulopathy not compatible with performing a deep gesture

• Pregnant woman and breastfeeding woman

• Presence of motor deficit

• Pain less than 4/10 (ENA)

• Patient protected by law