Evid Based Spine Care J 2011; 2(4): 13-18
DOI: 10.1055/s-0031-1274752
Original research
© AOSpine International Stettbachstrasse 6 8600 Dübendorf, Switzerland

Platelet-rich plasma effects on degenerative disc disease: analysis of histology and imaging in an animal model

Gregory B Gullung
1   Department of Orthopaedics, University of Mississippi Medical Center, Jackson, MS, USA
W Brinker Woodall
1   Department of Orthopaedics, University of Mississippi Medical Center, Jackson, MS, USA
Michelle A Tucci
1   Department of Orthopaedics, University of Mississippi Medical Center, Jackson, MS, USA
Judy James
2   Department of Radiology, University of Mississippi Medical Center, Jackson, MS, USA
David A Black
1   Department of Orthopaedics, University of Mississippi Medical Center, Jackson, MS, USA
Robert A McGuire
1   Department of Orthopaedics, University of Mississippi Medical Center, Jackson, MS, USA
› Author Affiliations
Further Information

Publication History

Publication Date:
16 February 2012 (online)


Study design: Randomized controlled animal trial.

Objectives: To analyze the early and late phase effects of platelet-rich plasma (PRP) injection into and around the damaged intervertebral disc using an animal model, and to evaluate the needle puncture technique in creating a degenerative disc model.

Methods: The L4-L5 intervertebral disc of 18 adult Sprague-Dawley rats was injured with a 21-gauge needle. Animals received an immediate injection of PRP, or a delayed injection of PRP 2 weeks postinjury, or no further intervention (sham) (n = 6/group). Six uninjured controls were used. Magnetic resonance imaging (MRI) was performed for a control at time 0 and each group at 4 weeks postinjury, this allowed resolution of inflammation and an accurate assessment of healing. Specimens were collected from immediate PRP group at 2 and 4 weeks postinjury, and the delayed PRP group at 4 and 6 weeks postinjury. The sham and control specimens were collected at 2, 4, and 6 weeks postinjury. Each disc was sectioned and analyzed subjectively for overall structure, cellularity, and water content (utilizing MRI). Disc height was measured using descriptive statistics and one-way analysis of variance (ANOVA) with Tukey post hoc analysis. It was presumed both groups injected with PRP would have better outcomes than the sham group.

Results: The sham group had clear degenerative changes with loss of organizational structure, empty space, fibrous tissue, and inflammatory cells, indicating needle puncture leads to degeneration. The PRP treated groups had fibers that were damaged with empty spaces and inflammatory cells. However, there was maintenance of the ring structure and the nucleus appeared to have a healthy central portion. Overall, both PRP - treated groups retained more normal morphologic features, contained fewer inflammatory cells, and had higher fluid content on MRI; however the effect was more pronounced in the immediate injection group. The disc height was significantly different in the sham and immediate injection group at the 4-week interval.

Conclusions: This percutaneous needle puncture technique is an effective method for creating a degenerative disc model without posterior destabilization of the spine. The administration of PRP has a protective effect on damaged discs in the acute and delayed injection settings representing clinical treatment with PRP in the early versus late stages of the degenerative process. It appears that earlier intervention in the disease process would be more beneficial than PRP treatment of already severely degenerated discs.


    • 1 Gaweda K, Tarczynska M, Krzyzanowski W. 2010; Treatment of Achilles tendinopathy with platelet-rich plasma. Int J Sports Med 31 (8) 577-583
    • 2 Gosens T, Peerbooms JC, van Laar W. 2011; Ongoing positive effect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: a double-blind randomized controlled trial with 2-year follow-up. Am J Sports Med 39 (6) 1200-1208
    • 3 Elliott DM, Yerramalli CS, Beckstein JC. 2008; The effect of relative needle diameter in puncture and sham injection animal models of degeneration. Spine (Phila Pa 1976) 33 (6) 588-596
    • 4 El-Sharkawy H, Kantarci A, Deady J. 2007; Platelet-rich plasma: growth factors and pro- and anti-inflammatory properties. J Periodontal 78 (4) 661-669
    • 5 Akeda K, An HS, Pichika R. 2006; Platelet-rich plasma (PRP) stimulates the extracellular matrix metabolism of porcine nucleus pulposus and anulus fibrosis cells cultured in alginate beads. Spine (Phila Pa 1976) 33 (9) 959-966
    • 6 Chen WH, Lo WC, Lee JJ. 2006; Tissue-engineered intervertebral disc and chondrogenesis using human nucleus pulposus regulated through TGF-beta1 in platelet-rich plasma. J Cell Physiol 209 (3) 744-754
    • 7 Chen WH, Liu HY, Lo WC. 2009; Intervertebral disc regeneration in an ex vivo culture system using mesenchymal stem cells and platelet-rich plasma. Biomaterials 30 (29) 5523-5533
    • 8 Sawamura K, Ikeda T, Nagae M. 2009; Characterization of in vivo effects of platelet-rich plasma and biodegradable gelatin hydrogel microspheres on degenerated intervertebral discs. Tissue Eng Part A 15 (12) 3719-3727
    • 9 Nagae M, Ikeda T, Mikami Y. 2007; Intervertebral disc regeneration using platelet-rich plasma and biodegradable gelatin hydrogel microspheres. Tissue Eng 13 (1) 147-158
    • 10 Tucci M, Scott V, Wingerter S. 2010; Evaluation of cartilage growth following sustained delivery of tgf-β using a rat degenerated disc model: biomed 2010. Biomed Sci Instrum 46: 142-147
    • 1 Hall MP, Band PA, Meislin RJ et al. 2009; Platelet-rich plasma: current concepts and application in sports medicine. J Am Acad Orthop Surg 17 (10) 602-608