According to a survey, about 632 million people around the world are suffering from low back pain (LBP), of which 68% are adults over 60 years old. LBP has become the main cause of reduced productivity and disability, posing a serious threat to personal health and socioeconomic development. Intervertebral disc disease (IVDD) is related to 40% to 50% of LBP and is one of the most common causes of LBP.

IVDD is a progressive chronic disease. The pathological mechanism is not fully understood. It may be related to changes in gene expression, repeated mechanical stimulation, poor nutritional supply, estrogen deficiency, and other internal environmental factors, as well as risk factors such as obesity, smoking, and atherosclerosis. Because the intervertebral disc lacks nourishment from nerves and blood vessels, its self-healing ability is poor, and treatment usually requires clinical intervention. Traditional treatments for IVDD include bed rest, physical therapy, anti-inflammatory and analgesic drugs, and surgery, but these can only relieve the patient's clinical symptoms and cannot delay or reverse the progression of IVDD. 

In recent years, with the development of molecular biology, scholars have turned their attention to biological therapies at the cellular, molecular, and genetic levels, trying to find a safe and effective method to prevent or even reverse the pathological process of IVDD. Currently, many growth factors have been shown to promote intervertebral disc cell proliferation and extracellular matrix synthesis, but the use of one growth factor alone cannot produce satisfactory results. However, platelet-rich plasma (PRP) separated from autologous blood is a natural carrier of various growth factors.

Numerous studies have shown that PRP can delay IVDD by promoting tissue repair and cell growth, and has a good analgesic effect. It has been widely used to repair various avascular tissues. Therefore, PRP not only effectively avoids immune responses and the occurrence of infectious diseases, but also provides a promising new method for the treatment of IVDD. However, the clinical treatment of IVDD by PRP is still in its preliminary stage, and the country has not yet proposed a unified industry treatment standard. 

PRP is a platelet concentrate extracted from autologous peripheral blood after centrifugation and contains superphysiological concentrations. Its main components are growth factors, inflammatory cells, and adhesion molecules. In addition to its advantages of not causing immune rejection and avoiding the spread of infectious diseases, its price is also acceptable to most patients, and it can be prepared in a routine hospital environment. These growth factors have powerful effects in promoting proliferation, cell migration, and synthesis of extracellular matrix proteins and collagen. The diversity of preparation processes and equipment results in different leukocyte and fibrin content in PRP. Researchers divide PRP into four categories: pure PRP (pure platelet-rich plasma, P-PRP), leukocyte-rich PRP (leucocyte-rich platelet-rich plasma (L-PRP), pure platelet-rich fibrin (P-PRF), and leucocyte rich platelet-rich fibrin (leucocyte rich platelet-rich fibrin, L-PRF). The adhesion protein in PRP has a unique three-dimensional network structure, which is conducive to the attachment of oxygen and cytokines around it, thereby inducing the regeneration of new tissue. Therefore, P-PRF and L-PRF can promote the osteogenic differentiation of stem cells, which can as a stem cell carrier and tissue engineering scaffold, it can promote stem cell therapy and has good application prospects. The inflammatory cells in PRP are mainly white blood cells, which can promote cartilage regeneration and have a strong bactericidal effect.

Regarding concentration, high concentrations of PRP will inhibit cell proliferation, while low concentrations of PRP will have a long-term positive impact on cell proliferation. Studies have found that 2.5% PRP has the best effect on promoting cell proliferation. In terms of time, platelets have the strongest effect on tissue repair at the onset of inflammation. Therefore, when administering PRP therapy, appropriate timing may be more important than concentration. PRP is currently widely used in wound healing and tissue regeneration in orthopedics, dentistry, and plastic surgery. It has been proven to promote angiogenesis, cell proliferation, and collagen synthesis, and can repair tendons, ligaments, cartilage, and other non-vascular-damaged tissue with low self-healing ability. It plays an anti-inflammatory, and analgesic and improves motor function role. In addition, PRP also has a restorative effect on atrophic multifidus muscles and compressed nerve roots. It has broad prospects in chronic low back pain and is a safe, effective, and feasible treatment method for IVDD.

The mechanism of PRP repairing IVDD mainly includes three aspects: inhibiting inflammatory response, inhibiting cell apoptosis, promoting cell proliferation, and increasing extracellular matrix. Although clinical trial protocols for PRP treatment of IVDD vary, almost all studies have confirmed that patients after PRP injections have experienced significant improvements in pain and dysfunction. 

In recent years, PRP, as a minimally invasive biological therapy, has effectively reduced patients’ hospitalization time and fear of surgery. It can achieve treatment goals without destroying spinal biomechanics. It has been gradually used in the treatment of IVDD. , most clinical trials have reported excellent results without obvious adverse reactions and complications. Therefore, PRP is a safe, simple, and effective therapy that can be used for the treatment of IVDD and has broad application prospects.