European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026 · 系統性回顧（依標題推測）
Platelet-rich plasma and stem cell therapies for spondylosis: a systematic review of randomized controlled trials.
腰椎 · 腰椎退化性疾病
中文閱讀摘要
PRP對腰椎神經根痛和腰椎關節痛有持久益處。
原始摘要
Background
Spinal spondylosis - including degenerative disc disease, facet arthropathy, and stenosis - is a leading cause of chronic spinal pain. Regenerative biologics such as platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and mesenchymal cell therapies are increasingly used, yet evidence remains inconsistent. This systematic review synthesizes randomized controlled trials (RCTs) evaluating biologic injections for degenerative spinal conditions.
Methods
MEDLINE, Embase, and Cochrane CENTRAL databases were searched from inception to September 22, 2025. Only RCTs evaluating PRP, BMAC, mesenchymal stem/stromal cells (MSCs), or mesenchymal precursor cells (MPCs) for degenerative spinal pain were included. Outcomes included pain, function, imaging, and adverse events. Risk of bias was assessed using Cochrane RoB 2.
Results
Thirteen RCTs met eligibility. For lumbar radiculopathy, four trials showed that corticosteroids provided faster early relief, but PRP produced significantly greater improvement at 3-6 months, with higher proportions achieving clinically meaningful pain and ODI reduction. In facetogenic pain, lumbar facet PRP surpassed steroids at 6 months, whereas cervical facet outcomes were similar across groups. Evidence for intradiscal PRP was mixed: one large RCT showed no benefit versus saline; smaller trials reported delayed functional gains. While autologous BMAC and MSC preparations did not demonstrate superiority over sham controls for primary pain and functional outcomes (Levi 2025, Vadalà 2025), allogeneic MPCs demonstrated significant, durable improvements in both pain and disability compared to saline through 36 months, particularly when delivered in a hyaluronic acid vehicle (Amirdelfan 2021). In contrast, a large multicenter RCT demonstrated that allogeneic MPCs significantly increased the proportion of patients achieving ≥ 10-15-point ODI improvement and durable pain reduction over 12-36 months (Amirdelfan 2021). Across all studies, adverse events were minimal, though one case of spondylodiscitis followed intradiscal PRP.
Conclusion
PRP provides durable mid-term benefit for lumbar radiculopathy and lumbar facet pain, while intradiscal PRP, BMAC, and autologous MSCs show limited efficacy. Allogeneic MPCs are the most promising cell-based therapy but remain investigational. Standardization of biologic preparation and larger, multicenter RCTs are needed.
至 Europe PMC 閱讀完整來源 ↗ · 擷取日期 2026-10-19
書目、來源與全文狀態
- DOI
- 10.1007/s00586-026-09997-9
- PMID／PMCID
- 42141193
- 作者
- Zhang RE, Aurangzeb A, Sirisena D
- 首次發表日期
- 2026-05-16Europe PMC 提供，部分日期可能依年份或月份推定。
- 卷／期／頁碼或文章編號
- 卷未提供 ／ 期未提供 ／ 頁碼或文章編號未提供
- 書目來源與查核日期
- Europe PMC · 2026-10-19僅核對書目欄位與來源連結；不代表已評讀研究品質。
- 全文與授權
- 來源尚未確認免費全文。 來源授權標示：cc by。
可回溯引用
Zhang RE, Aurangzeb A, Sirisena D. Platelet-rich plasma and stem cell therapies for spondylosis: a systematic review of randomized controlled trials. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2026. PMID: 42141193. doi:10.1007/s00586-026-09997-9
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