Biologic treatments for back pain not supported by high-quality evidence, study finds

Biologics

Researchers sought to examine the effectiveness of intradiscal biologics for treating discogenic low back pain and found low-quality evidence supporting it, according to a study published in the February 2022 edition of The Spine Journal.

Four things to know:

1. Researchers examined literature between 2018 and 2020 related to biologic treatments including mesenchymal stem cells, platelet rich plasma, microfragmented fat, amniotic membrane-based injectates and autologous conditioned serum.

2. Thirty-seven studies were identified for full-text review. The studies were independently reviewed. One randomized trial showed positive outcomes but also had significant methodological flaws. A trial evaluating mesenchymal stem cells was negative.

3. In aggregate, success rates for platelet-rich plasma injectate were 54.8 percent. The aggregate success for mesenchymal stem cells at six months was 53.5 percent.

4. The study concluded: "Limited observational data support the use of intradiscal biologic agents for the treatment of discogenic low back pain. According to the Grades of Recommendation, Assessment, Development and Evaluation System, the evidence supporting use of intradiscal mesenchymal stem cells and platelet-rich plasma is very low quality."

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