EPIDURAL PRP

[PinchandBurn]

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Those of you that are doing PRP / orthobiologics for the "FSU"

You are putting it in the Epidural Space presumably as well.

Question. In order to obtain the PRP there's usually Anticoagulant in the tubes. Is it safe to then use that PRP in the epidural space? To me this would seem counter to what we do.....

Placing into the facets and other structures..no big deal. Thoughts?

 

[pmrmd]

All I know is when I used PRP for my supraspinatus tear I wanted to chop my arm off the entire next day. Same for my hip. LR or LP I’m not sure I want to try it personally.

 

[painisfear]

Apparently that small dose of anticoagulant does not phase anybody who is actually injecting into the epidural space. I’m at the TOBI/ASIPP conference and have been asking around to understand protocols.

 

[PinchandBurn]

Apparently that small dose of anticoagulant does not phase anybody who is actually injecting into the epidural space. I’m at the TOBI/ASIPP conference and have been asking around to understand protocols.

Dude. Ask someone there. I would have i went last year to tobi...

I didnt care or think about it before as I was jist doing joints. But epidural is different story. It seems like thats where its heading.

 

[painisfear]

I have asked them and they do not feel it is problematic.

 

[PinchandBurn]

Apparently that small dose of anticoagulant does not phase anybody who is actually injecting into the epidural space. I’m at the TOBI/ASIPP conference and have been asking around to understand protocols.

Dude. Ask someone there. I would have i went last year to tobi...

I didnt care or think about it before as I was jist doing joints. But epidural is different story. It seems like thats where its heading.

I have asked them and they do not feel it is problematic.

The people I asked didnt care either...Judlst counterintuitive

 

[bedrock]

Those of you that are doing PRP / orthobiologics for the "FSU"

You are putting it in the Epidural Space presumably as well.

Question. In order to obtain the PRP there's usually Anticoagulant in the tubes. Is it safe to then use that PRP in the epidural space? To me this would seem counter to what we do.....

Placing into the facets and other structures..no big deal. Thoughts?

I’ve done it many times, Including today.
Double spin kit. People do fine 95% of the time.

 

[callmeanesthesia]

I’ve done it many times, Including today.
Double spin kit. People do fine 95% of the time.

You mean they get relief 95% of the time? Because that’s hard to believe. Or do you mean 95% of the time the anticoagulant isn’t a problem? Because that’s concerning.

 

[mille125]

You mean they get relief 95% of the time? Because that’s hard to believe. Or do you mean 95% of the time the anticoagulant isn’t a problem? Because that’s concerning.

same question

 

[bedrock]

You mean they get relief 95% of the time? Because that’s hard to believe. Or do you mean 95% of the time the anticoagulant isn’t a problem? Because that’s concerning.

I was responding to the OP.

95% of PRP-LP epidurals do not result in significantly increased post procedural pain.

 

[PinchandBurn]

I was responding to the OP.

95% of PRP-LP epidurals do not result in significantly increased post procedural pain.

ok
but your kit like mine (emcyte) contains anticoagulant. No problems?

I did a Cervical epidural with PRP. I was kind of scared about it as after the fact realized anticoag is in there, but nothing happened. My n=1.

I called my former PD who does a lot of orthobiolgics. He goes its a only a 'small' amount of anticoag so dont worry he does it all the time. My issues are what does "small" amount mean. I suppose in the Lumbar it's one thing. I'm not sure I would do it again in the CERVICAL. Unless this patient feels amazing and this does well. First day she had no increased pain. POD1 had increased pain, but tolerable. I did give her some tramadol and gave her the spiel that she may hate me for a few days. But long term hpefully improves. Whether people on here like it or not, Orthobiologics is here to stay. We gotta figure out how to use it..

 

[clubdeac]

ok
but your kit like mine (emcyte) contains anticoagulant. No problems?

I did a Cervical epidural with PRP. I was kind of scared about it as after the fact realized anticoag is in there, but nothing happened. My n=1.

I called my former PD who does a lot of orthobiolgics. He goes its a only a 'small' amount of anticoag so dont worry he does it all the time. My issues are what does "small" amount mean. I suppose in the Lumbar it's one thing. I'm not sure I would do it again in the CERVICAL. Unless this patient feels amazing and this does well. First day she had no increased pain. POD1 had increased pain, but tolerable. I did give her some tramadol and gave her the spiel that she may hate me for a few days. But long term hpefully improves. Whether people on here like it or not, Orthobiologics is here to stay. We gotta figure out how to use it..

Yes experimentation on patients is best 😉

 

[PinchandBurn]

Yes experimentation on patients is best 😉

Haha

I only did it because others have. The literature is growing about it vs esi...

That said not sure why no one else has asked the question about anticoag at these confernces (including myselfL.