Journal of clinical orthopaedics and trauma · 2026
A randomized controlled trial comparing transforaminal injections of Platelet-rich plasma versus steroid for lumbar herniated disc.
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Sonkar T, Yadav V, Singh S
Аннотация
BACKGROUND: Transforaminal steroid injections are a standard treatment for lumbosacral radiculopathy but primarily offer short-term anti-inflammatory benefits. Concerns regarding the limited duration of steroids have prompted interest in biological alternatives like PRP, which may promote tissue healing and provide longer-lasting relief.
METHODS: Study was registered under CTRI (Registration no. CTRI/2025/10/096579). 107 patients with symptomatic, MRI-confirmed single-level lumbar herniated disc failing six weeks of conservative treatment were randomized. Group A received 1 mL triamcinolone (steroid), 40 mg/mL with 2 mL 0.25% bupivacaine. Group B received 3 mL autologous PRP prepared via a double-spin protocol. Primary and secondary outcomes were 10-point Visual Analog Scale (VAS) and Oswestry Disability Index (ODI), assessed at baseline and 1, 3, 6, and 12 weeks post-injection.
RESULTS: Both groups showed significant improvement from baseline. At 1 and 3 weeks, the steroid group demonstrated significantly lower VAS and ODI scores. However, at 6 and 12 weeks, the PRP group exhibited superior outcomes; specifically, the 12-week mean VAS score was significantly lower in the PRP group compared to the steroid group. No complications were reported in either cohort.
CONCLUSIONS: While transforaminal steroid provides rapid short-term relief, autologous PRP injections demonstrate superior and more sustained clinical and functional outcomes at 12 weeks.
METHODS: Study was registered under CTRI (Registration no. CTRI/2025/10/096579). 107 patients with symptomatic, MRI-confirmed single-level lumbar herniated disc failing six weeks of conservative treatment were randomized. Group A received 1 mL triamcinolone (steroid), 40 mg/mL with 2 mL 0.25% bupivacaine. Group B received 3 mL autologous PRP prepared via a double-spin protocol. Primary and secondary outcomes were 10-point Visual Analog Scale (VAS) and Oswestry Disability Index (ODI), assessed at baseline and 1, 3, 6, and 12 weeks post-injection.
RESULTS: Both groups showed significant improvement from baseline. At 1 and 3 weeks, the steroid group demonstrated significantly lower VAS and ODI scores. However, at 6 and 12 weeks, the PRP group exhibited superior outcomes; specifically, the 12-week mean VAS score was significantly lower in the PRP group compared to the steroid group. No complications were reported in either cohort.
CONCLUSIONS: While transforaminal steroid provides rapid short-term relief, autologous PRP injections demonstrate superior and more sustained clinical and functional outcomes at 12 weeks.