# Leukocyte poor platelet rich plasma vs leukocyte rich platelet rich plasma as a treatment for cervical facetogenic pain: A pooled analysis

## TL;DR

This study compares two types of platelet-rich plasma treatments for neck pain, finding that leukocyte-rich PRP may offer better long-term pain relief and function.

## Contribution

The study provides preliminary evidence that leukocyte-rich PRP may be more effective and safer than leukocyte-poor PRP for cervical facetogenic pain.

## Key findings

- LR-PRP showed greater pain and disability reduction at 6 months compared to LP-PRP.
- LR-PRP had no adverse events, while LP-PRP had more reported side effects.
- Findings suggest LR-PRP may be superior for long-term cervical pain management.

## Abstract

This study aimed to compare the effectiveness and safety of leukocyte-poor platelet-rich plasma (LP-PRP) and leukocyte-rich platelet-rich plasma (LR-PRP) for the treatment of cervical facetogenic pain through a pooled analysis of two independent studies. The goal was to provide preliminary evidence comparing the effect on pain relief and functional improvement over time to help inform future research.

The pooled analysis integrated data from two studies: a prospective case series of LR-PRP (n = 36) and a randomized controlled trial (RCT) comparing LP-PRP (n = 21) with corticosteroid injections. Participants in both studies had chronic cervical facetogenic pain confirmed through medial branch blocks and were assessed at baseline, 3 months, and 6 months post-injection. Pain intensity was measured using the Numerical Pain Rating Scale (NRS), and functional disability was assessed using the Neck Disability Index (NDI). Linear mixed-effects models evaluated treatment effects over time, controlling for age, sex, and pain duration. Clinically important differences in pain and disability were determined. Adverse events were also recorded.

Both PRP groups exhibited significant improvements in pain and functional outcomes. However, LR-PRP demonstrated superior efficacy at 6 months, with a greater reduction in NRS scores (β = −1.68, p < 0.01, Cohen's d = −1.15) and NDI scores (β = −3.66, p = 0.02, Cohen's d = −0.94) compared to LP-PRP. A higher proportion of LR-PRP participants achieved clinically significant pain relief (≥2-point NRS reduction) and functional improvement (≥10 % NDI reduction) at 6-months. No significant differences were observed at 3 months. Adverse events were more common in the LP-PRP group, with 11 documented cases, including increased pain and muscle spasms, whereas the LR-PRP group reported no adverse events.

These preliminary findings suggest that LR-PRP appears to provide greater long-term benefits for cervical facetogenic pain compared to LP-PRP, with superior pain reduction, improved function, and a favorable safety profile. These findings suggest the higher leukocyte concentration in LR-PRP may enhance therapeutic outcomes for cervical pain. Further large-scale, randomized trials are necessary to confirm these results and establish standardized PRP preparation protocols.

•LR-PRP may offer more long-term benefits than LP-PRP for cervical facetogenic pain.•Preliminary evidence for superior pain, function, and safety outcomes for LR-PRP.•These findings suggest LR-PRP may be superior and warrant future RCT confirmation.

LR-PRP may offer more long-term benefits than LP-PRP for cervical facetogenic pain.

Preliminary evidence for superior pain, function, and safety outcomes for LR-PRP.

These findings suggest LR-PRP may be superior and warrant future RCT confirmation.