A Systematic Review of Regenerative Medicine Therapies for Axial Spine Pain of Facet Joint Origin. March 2025
Spinal pain resulting from facet joint irritation, inflammation or degeneration is a very common complaint that can be considerably difficult to treat in some cases. Fortunately, the majority of cases are managed well conservatively with manual therapy and physical therapy. In some cases, injection therapy can be used to aid healing and reduce inflammation.
This recent review looks to assess the effectiveness of regenerative injection therapy for spinal pain, specifically mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) injection therapy. A systematic evaluation of available evidence on these biological therapies was conducted to determine their clinical effectiveness.
FINDINGS
Recent studies show the therapeutic value of joint biologic treatments, including MSCs, PRP, and alpha-2-macroglobulin, in managing facet joint relation spinal pain. Recent clinical evidence has suggested improvements in pain relief, physical function, and quality of life following regenerative biologic treatments.
From this review, 20 studies were identified and included (4 randomised controlled trials and 6 observational studies). Among the controlled trials, 3 used lumbar spine facet joints, and one trial involved cervical neck facet joints using PRP injection therapy. Observational studies - 4 used PRP, 3 on the lumbar spine and one study, with 2 studies, on the cervical spine, and only 2 studies investigated stem cell therapy.
Overall, the evidence for PRP injections in facet joints is moderate at Level II. For PRP, the recommendation is moderate, provided some reasonable clinical evidence clinical use in spinal pain. Whereas for MSCs, the recommendation is weak.
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Dynamic Regenerative Medicine
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