![]() 13 On the other hand, annulus fibrosus (AF) tears in the posterior AF area are known as high-intensity zones (HIZs) and are observed as high-intensity signals on T2-weighted magnetic resonance (MR). A previous report showed that 39% of the chronic LBP patients had the presence of internal disc disruption evaluated by computed tomography (CT) images. Because of the absence of blood supply, IVD tissues have little potential for self-repair. The progression of IVD degeneration is known to lead to ruptures (including tears and/or cleft formation) within IVD tissues. 8, 12 DePalma et al 10 also reported that younger patients tend to have a higher probability of having a discogenic origin of LBP. 8, 9, 11 A cross-sectional study of young individuals from 13 to 20 years of age showed a stronger correlation between disc degeneration and LBP than that of adult populations. 4 – 10Įpidemiological studies on large population samples have recently provided evidence that LBP has a significant association with lumbar disc degeneration. However, recent epidemiological, radiological, and clinical studies have shown accumulating evidence that the specific nociceptive origin of LBP can be identified by a comprehensive diagnosis including radiological, interventional, and physical examinations by spine and/or orthopedic specialists. Traditionally, the notion that the cause of LBP is unclear in about 85% of the patients, referred to as having “nonspecific LBP”, has been perpetrated over recent decades. 3 The authors of GDB 2015 suggest that LBP should be a priority for future research on prevention and therapy. ![]() More recently, the Global Burden of Disease (GBD) in 2015 reported that the global point prevalence of activity-limiting LBP was 7.3% (540 million people in the world), and LBP is now regarded as the first cause of disability worldwide. Therefore, LBP has a major societal economic impact. ![]() 2 Several epidemiological studies have shown that the prevalence of LBP was highest during middle age. An international survey of pain from the data of the Health Behavior in School-aged Children: WHO collaborative cross-national survey (HBSC) showed that 37.0% of the adolescents reported LBP monthly or more frequently. 1 The prevalence of LBP was higher among females than among males across all age groups and was relatively high during adolescence. In 2012, a systematic review of the global prevalence of LBP reported that the point prevalence of activity-limiting LBP was estimated to bê12%, whereas the 1-month prevalence was 23%. LBP, an extremely common symptom in populations of all ages from children to the elderly, is significantly associated with personal, social, and economic burdens worldwide. Further large-scale studies may be required to confirm the clinical evidence of PRP for the treatment of discogenic LBP.Įpidemiology of low back pain (LBP) and its association with intervertebral disc (IVD) degeneration While the clinical evidence of tissue repair of IVDs by PRP treatment is currently lacking, there is a great possibility that the application of PRP has the potential to lead to a feasible intradiscal therapy for the treatment of degenerative disc diseases. Although there was only one double-blind randomized controlled trial, all the studies reported that PRP was safe and effective in reducing back pain. Clinical studies for evaluating the effects of the injection of PRP into degenerated IVDs for patients with discogenic LBP have been reviewed. The results of this basic research have shown the great possibility that PRP has significant biological effects for tissue repair to counteract IVD degeneration. Several animal studies have shown that the injection of PRP into degenerated IVDs is effective in restoring structural changes (IVD height) and improving the matrix integrity of degenerated IVDs as evaluated by magnetic resonance imaging (MRI) and histology. PRP has great potential to stimulate cell proliferation and metabolic activity of IVD cells in vitro. Platelet-rich plasma (PRP) is an autologous blood concentrate that contains a natural concentration of autologous growth factors and cytokines and is currently widely used in the clinical setting for tissue regeneration and repair. Intervertebral disc (IVD) degeneration is an important pathogenesis of LBP. Low back pain (LBP) is now regarded as the first cause of disability worldwide and should be a priority for future research on prevention and therapy.
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