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Research ArticleOriginal Article
Open Access

The role of intra-articular injection of autologous platelet-rich plasma versus corticosteroids in the treatment of synovitis in lumbar facet joint disease

Shahdan Y. Kotb, Nahed M. Sherif, Hala A. Saleh, Sahar F. Ahmed, Hossam M. Sakr and Mohamed O. Taeimah
Saudi Medical Journal November 2022, 43 (11) 1200-1208; DOI: https://doi.org/10.15537/smj.2022.43.11.20220449
Shahdan Y. Kotb
From the Department of Physical Medicine, Rheumatology and Rehabilitation (Kotb, Sherif, Saleh, Ahmed); from the Department of Radiodiagnosis (Sakr); and from the Department of Anesthesiology, Intensive Care and Pain Management (Taeimah), Faculty of Medicine, Ain Shams University, Cairo, Egypt.
MD
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  • For correspondence: [email protected]
Nahed M. Sherif
From the Department of Physical Medicine, Rheumatology and Rehabilitation (Kotb, Sherif, Saleh, Ahmed); from the Department of Radiodiagnosis (Sakr); and from the Department of Anesthesiology, Intensive Care and Pain Management (Taeimah), Faculty of Medicine, Ain Shams University, Cairo, Egypt.
MD, PhD
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Hala A. Saleh
From the Department of Physical Medicine, Rheumatology and Rehabilitation (Kotb, Sherif, Saleh, Ahmed); from the Department of Radiodiagnosis (Sakr); and from the Department of Anesthesiology, Intensive Care and Pain Management (Taeimah), Faculty of Medicine, Ain Shams University, Cairo, Egypt.
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Sahar F. Ahmed
From the Department of Physical Medicine, Rheumatology and Rehabilitation (Kotb, Sherif, Saleh, Ahmed); from the Department of Radiodiagnosis (Sakr); and from the Department of Anesthesiology, Intensive Care and Pain Management (Taeimah), Faculty of Medicine, Ain Shams University, Cairo, Egypt.
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Hossam M. Sakr
From the Department of Physical Medicine, Rheumatology and Rehabilitation (Kotb, Sherif, Saleh, Ahmed); from the Department of Radiodiagnosis (Sakr); and from the Department of Anesthesiology, Intensive Care and Pain Management (Taeimah), Faculty of Medicine, Ain Shams University, Cairo, Egypt.
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Mohamed O. Taeimah
From the Department of Physical Medicine, Rheumatology and Rehabilitation (Kotb, Sherif, Saleh, Ahmed); from the Department of Radiodiagnosis (Sakr); and from the Department of Anesthesiology, Intensive Care and Pain Management (Taeimah), Faculty of Medicine, Ain Shams University, Cairo, Egypt.
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  • Article
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Article Figures & Data

Tables

    • View popup
    Table 1

    - Comparative results in Group I (platelet-rich plasma injection).

    ParametersBeforeAfterTest value*P-valueSig.
    n=15n=15
    Ex. ROM     
    Range15–3419–344.3630.001HS
    Mean ± SD23.60 ± 5.3726.53 ± 4.09
    VAS     
    Range7–94–7−9.934<0.001HS
    Mean ± SD8.00 ± 0.765.73 ± 0.88
    RMQ     
    Range12–2210–18−10.717<0.001HS
    Mean ± SD19.33 ± 2.5514.27 ± 2.37
    ODI     
    Range32–7038–64−4.979<0.001HS
    Mean ± SD58.13 ± 10.4347.60 ± 7.06

    p>0.05: not significant (NS), p<0.05: significant (S), p<0.01: highly significant (HS), RMQ: Roland Morris Questionnaire, ODI: Oswestry Disability Index, Ex. ROM: extension range of motion, VAS: visual analogue scale, *: paired t-test

      • View popup
      Table 2

      - Comparison between MRI lumbar facet joints synovitis grading before and after the intervention in Group I receiving platelet-rich plasma at each lumbar level.

      MRIBeforeAfterTest value*P-valueSig.
      n%n%
      L1-2 (n=5 [16.7%])
      Grade L1-2       
      Grade 000.0480.06.8000.033S
      Grade I480.0120.0
      Grade II120.000.0
      L2-3 (n= 7 [76.7%])
      Grade L2-3       
      Grade 000.0685.710.5710.005HS
      Grade I685.7114.3
      Grade II114.300.0
      Grade III00.000.0
      L3-4 (n=9 [70.0%])
      Grade L3-4       
      Grade 000.0777.811.4550. 001HS
      Grade I9100.0222.2
      Grade II00.000.0
      Grade III00.000.0
      L4-5 (n=11 [63.3%])
      Grade L4-5       
      Grade 000.0763.611.6000.009HS
      Grade I872.7218.2
      Grade II218.2218.2
      Grade III19.100.0
      L5-S1 (n=13 [56.7%])
      Grade L5–S1       
      Grade 000.0646.28.0000.018S
      Grade I1076.9646.2
      Grade II323.117.7
      Grade III00.000.0

      p>0.05: not significant (NS), p<0.05: significant (S), p<0.01: highly significant (HS), *:Chi-square test, MRI: magnetic resonance imaging

        • View popup
        Table 3

        - Comparative results in group II (Corticosteroids).

        ParametersBeforeAfterTest value*P-valueSig.
        n=15n=15
        Ex. ROM     
        Range10–3018–326.808<0.001HS
        Mean ± SD21.47 ± 6.5825.53 ± 4.70
        VAS     
        Range7–93–7−10.044<0.001HS
        Mean ± SD8.07 ± 0.805.73 ± 1.39
        RMQ     
        Range12–2210–19−8.503<0.001HS
        Mean ± SD19.13 ± 2.4515.20 ± 2.37
        ODI     
        Range32–7228–60−8.270<0.001HS
        Mean ± SD61.60 ± 10.6250.13 ± 10.70

        p>0.05: not significant (NS); p<0.05: significant (S); p<0.01: highly significant (HS); RMQ: Roland Morris Questionnaire; ODI: Oswestry Disability Index; Ex. ROM: Extension range of motion; VAS: visual analogue scale; •: paired t-test

          • View popup
          Table 4

          - Comparison of lumbar facet joint synovitis grading on MRI before and after the intervention in Group II receiving corticosteroids.

          MRIBeforeAfterTest value*P-valueSig.
          n%n%
          L1–2 (n=2 (6.7%))
          Grade L1–2       
          Grade 000.0150.01.3330.248NS
          Grade I2100.0150.0
          Grade II00.000.0
          Grade III00.000.0
          L2–3 (n=1 (3.3%))
          Grade L2–3       
          Grade 000.01100.02.0000.157NS
          Grade I1100.000.0
          Grade II00.000.0
          Grade III00.000.0
          L3–4 (n=7 (23.3%))
          Grade L3–4       
          Grade 000.0342.95.6190.132NS
          Grade I571.4228.6
          Grade II114.3228.6
          Grade III114.300.0
          L4–5 (n=13 (43.3%))
          Grade L4–5       
          Grade 000.0323.19.7140.021S
          Grade I538.5969.2
          Grade II646.217.7
          Grade III215.400.0
          L5–S1 (n=13 (46.7%))
          Grade L5–S1       
          Grade 000.0753.811.3280.001HS
          Grade I753.8646.1
          Grade II646.100.0
          Grade III00.000.0

          p>0.05: not significant (NS), p<0.05: significant (S), p<0.01: highly significant (HS), *: Chi-square test, MRI: magnetic resonance imaging

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          The role of intra-articular injection of autologous platelet-rich plasma versus corticosteroids in the treatment of synovitis in lumbar facet joint disease
          Shahdan Y. Kotb, Nahed M. Sherif, Hala A. Saleh, Sahar F. Ahmed, Hossam M. Sakr, Mohamed O. Taeimah
          Saudi Medical Journal Nov 2022, 43 (11) 1200-1208; DOI: 10.15537/smj.2022.43.11.20220449

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          The role of intra-articular injection of autologous platelet-rich plasma versus corticosteroids in the treatment of synovitis in lumbar facet joint disease
          Shahdan Y. Kotb, Nahed M. Sherif, Hala A. Saleh, Sahar F. Ahmed, Hossam M. Sakr, Mohamed O. Taeimah
          Saudi Medical Journal Nov 2022, 43 (11) 1200-1208; DOI: 10.15537/smj.2022.43.11.20220449
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          Keywords

          • platelet rich plasma
          • corticosteroids
          • synovitis
          • lumbar facet joint

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