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Healing from trauma - Effect of platelet-rich plasma on post-traumatic neck injury resulting in muscle spasm
Zhong, X. [2]
Davalath, V. [1]
O'Donnell, A.

Journal: The AAO Journal Date: 2022/06, 32(2):Pages: 10. doi: Subito , type of study: case report

Free full text   (https://meridian.allenpress.com/aaoj/article/32/2/8/482676/LBORC-NUFA-Poster-Abstracts-2022-Residents)

Keywords:

case report [514]
chronic neck pain [12]
cervical spine [210]
muscle spasm [2]
platelet-rich plasma injections [1]
post-traumatic neck injury [1]

Abstract:

Introduction: Chronic neck pain is the second most frequent musculoskeletal complaint in the US. Conventional treatments are often symptom driven. Platelet-rich plasma (PRP) injections target core ligamentous injury to stabilize joints. This case depicts using PRP to heal chronic neck pain. Case: A man in his 40s presented for chronic neck pain following physical assault five years prior. His June 2020 MRI showed anterolisthesis of C5-C6, disc degeneration and bulging, arthritis changes of spinous processes C3-C6, and cervical lordotic curve flattening. Damage caused profound right-sided paraspinal muscle spasm; non-radicular, sharp right-sided neck pain worsening with left head rotation. Subjective pain rated 6/10, notably associated with headaches and bilateral tinnitus. PT, TENS, acupuncture, massage, rhizotomy, and Botox therapies were ineffective. PE revealed a negative Spurling test, C4-C6 right muscular spasm, and decreased cervical lordosis. Prolotherapy was completed one week later to the supraspinous and interspinous ligament attachments of C3-C7 resulted in significant but short-lasting improvement. Three PRP rounds were performed to these same ligaments of C3-T1. On the last round, right C4- C5 facet joint, splenius capitus, and semispinalis capitus attachments to the occiput were also injected. Results: After the second PRP, the patient’s baseline pain decreased to 1/10, initiated now-effective PT, with minimal headaches, decreased cervical muscle spasms, improved neck mobility, and greater receptiveness to trauma psychology counseling. After the third and last PRP, the patient was told to self-assess for possible additional treatment 3 months later, which he declined due to significant gains already achieved. Discussion: This case illustrates the benefits of PRP for chronic and/or refractory disease when all other treatment options have been exhausted. Study limitation: no post-treatment neck MRI comparing objective findings.


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