Evidence map›Paper›PMID 42334678›Full record

SynthesisCurrent pain and headache reports2026

A Systematic Review and Meta-Analysis of Randomized Controlled Trials of Epidural Regenerative Medicine Therapies in Managing Spinal Pain.

Laxmaiah Manchikanti, Alaa Abd-Elsayed, Max Y Jin, Alan D Kaye, Mahendra R Sanapati, Sairam Atluri, Navneet Boddu, Joshua A Hirsch

Abstract readSystematic ReviewMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Current pain and headache reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Laxmaiah ManchikantiPain Management Centers of America, 67 Lakeview Drive, Paducah, Evansville, KY, 42001, USA. drlm@thepainmd.com.ORCID http://orcid.org/0000-0002-4201-9063
Alaa Abd-ElsayedUW Health Pain Services, University of Wisconsin, Madison, WI, USA.ORCID http://orcid.org/0000-0002-9890-7860
Max Y JinUniversity of Wisconsin School of Medicine and Public Health, Madison, WI, USA.ORCID http://orcid.org/0009-0006-9524-4308
Alan D KayeDepartment of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, USA.ORCID http://orcid.org/0000-0003-2464-0187
Mahendra R SanapatiPain Management Centers of America, 67 Lakeview Drive, Paducah, Evansville, KY, 42001, USA.ORCID http://orcid.org/0000-0002-1047-0765
Sairam AtluriTri-State Spine Care Institute, Arete Hospitals, Cincinnati, Hyderabad, OH, India.
Navneet BodduAdvanced Pain & Regenerative Specialists, Oceanside, CA, USA.
Joshua A HirschMassachusetts General Hospital, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0001-5263-6535

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purpose of reviewThis review aims to assess the effectiveness of epidural injections of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) in treating chronic spinal pain. While existing literature has primarily concentrated on intradiscal regenerative therapies, this systematic review focuses specifically on the efficacy of PRP and MSCs when administered into the epidural space for managing chronic spinal pain. RECENT

findingsDue to their anti-inflammatory and regenerative properties, emerging studies underscore the therapeutic promise of epidural biologics, including MSCs, platelet-rich plasma, and alpha-2-macroglobulin. Epidural administration offers key advantages: it avoids the risk of discitis and minimizes the chance of disc injury from needle penetration. Moreover, this route enables simultaneous treatment of multiple affected discs without discography or multiple intradiscal injections. This is particularly relevant in elderly patients who often present with advanced disc degeneration and narrowed disc spaces, making intradiscal injections technically difficult. Clinical findings suggest notable improvements in pain reduction, physical functionality, and overall quality of life following these epidural treatments. A total of 9 randomized controlled trials (RCTs) were included in the review to evaluate epidural biologics for chronic spinal pain management. No RCTs investigating stem cells were identified. The quality of evidence was rated as fair (Level III), with moderate effect size and recommendation strength based on a qualitative synthesis and GRADE (Grading of Recommendations, Assessment, Development and Evaluations) methodology.

Indexed as

Chronic PainMesenchymal Stem Cell TransplantationPain ManagementPlatelet-Rich PlasmaRegenerative MedicineHumansInjections, EpiduralRandomized Controlled Trials as TopicChronic low back painChronic neck painChronic spinal painEpidural injectionsMesenchymal stem cellsPlatelet-rich plasma

Identifiers

PMID42334678

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.