Intradiscal Injections of Bone Marrow Concentrate or Leukocyte-Rich Platelet-Rich Plasma for the Treatment of Cervical Discogenic Pain: A Case Series

PURPOSE: Cervical discogenic pain is a prevalent and debilitating condition. In recent years, autologous regenerative therapies such as bone marrow concentrate (BMC) and platelet-rich plasma (PRP) have gained attention as potential alternatives to traditional interventional pain management. This study investigates the safety and efficacy of these treatments when delivered intradiscally as part of a comprehensive cervical functional spinal unit (FSU) approach. METHODS: This is a retrospective case series utilizing registry data, with 18 participants meeting the inclusion criteria. Intradiscal injections of BMC or leukocyte-rich PRP were guided by ultrasound and fluoroscopy with contrast confirmation. Patient-reported outcome measures (PROMs), including the Functional Rating Index (FRI), Numeric Pain Scale (NPS), and a modified Single Assessment Numeric Evaluation (SANE), were collected at baseline and at a minimum of three months post-treatment, with a mean follow-up of one year. RESULTS: Eleven participants received BMC injections, and seven received leukocyte-rich PRP injections. No adverse events were reported during the study period. Statistical analysis revealed a significant reduction in the NPS in half of the patients (9 of 18) (mean difference = -1.0, P = 0.024), while a majority (14 of 18) reported improvement in FRI scores (mean difference = -10.9, P = 0.015). The average SANE score was 60%, with most patients (14 of 18) reporting 50% or greater improvement. CONCLUSION: Intradiscal injections of BMC or LR-PRP as part of a comprehensive cervical FSU approach appear to be safe and effective for improving patient-reported pain and function. These findings support the potential of autologous biologics as an alternative treatment modality for cervical discogenic pain.