Conservative management of spinal pathology with autologous conditioned serum: A systematic review of the literature  

作　　者：Christian J Rajkovic Matthew L Merckling Alyssa W Lee Galadu Subah Aryan Malhotra Zachary D Thomas Sabrina L Zeller John V Wainwright Merritt D Kinon 

机构地区：[1]Department of Neurosurgery,Westchester Medical Center,Valhalla,NY 10595,United States

出　　处：《World Journal of Orthopedics》2024年第9期870-881,共12页世界骨科杂志（英文版）

摘　　要：BACKGROUND Chronic inflammatory pain is associated with increased expression of interleukin(IL)-1,an inflammatory cytokine,and activity on its receptor(IL-1R).In response,the body produces IL-1R antagonist(IL-1Ra)to reduce this signaling.Autologous conditioned serum(ACS)is the only biologic therapy for spinal pathologies that enhances the action of endogenous IL-1Ra reserves to improve symptoms.This systematic review investigates the effectiveness of ACS in treating pain and dis-ability caused by spinal pathologies.AIM To evaluate the use of ACS as a conservative management option for spinal path-ology.METHODS A systematic review of PubMed/Medline was performed to identify studies inve-stigating administration of ACS for treatment of any spinal pathology.RESULTS Six articles were included,comprising 684 patients treated with epidural(n=133)or transforaminal(n=551)ACS injections.Patients had an average age of 54.0 years with slight female predominance(53.2%).The lumbar spine was most com-monly treated,with 567 patients(82.9%)receiving injections for lumbar radicu-lopathy(n=67),degenerative disc disease(DDD)(n=372),or spinal stenosis(n=128);cervical injections were performed in 109 patients(15.9%).Mean(SD)follow-up was 21.7(4.8)weeks from first ACS injection.All studies investigating mecha-nical lumbar and lumbar or cervical radicular pain reported significant pain re-duction at final follow-up compared to baseline.ACS achieved comparable or su-perior results to lumbar epidural steroid injections.Adverse events were reported in 21 patients(3.1%),with no serious adverse events.CONCLUSION ACS injection is a safe and effective intervention for pain reduction in many spinal pathologies,including cervical and lumbar radiculopathies.

关 键 词：SPINE Autologous conditioned serum Orthokine Regenokine Epidural steroid injection INTERLEUKIN-1 Inter-leukin-1 receptor antagonist 

分 类 号：R684.3[医药卫生—骨科学]