Regenerative Management of Internal Disc Disruption with Platelet-rich Plasma: A Magnetic Resonance Imaging Supported Case Report

Abstract Internal disc disruption (IDD) is a recognized cause of chronic low back pain, often associated with annular tears and high-intensity zones (HIZs) on magnetic resonance imaging (MRI). Conventional treatments may offer limited relief, prompting exploration of regenerative therapies like platelet-rich plasma (PRP). A 30-year-old female presented with axial low back pain, unresponsive to conservative management for 8 months. Her MRI revealed an annular tear with HIZ at the L4–L5 intervertebral disc. Provocative discography confirmed IDD at this level; thus, an intradiscal autologous PRP Minimally Invasive Pain and Spine Intervention (MIPSI) was planned. The patient reported significant pain reduction using the Visual Analog Scale (VAS) score from 8/10 to 2/10 and functional improvement by the modified Oswestry Disability Index score at various follow-ups at 2 weeks, 1 month, 3 months, 6 months, and 1 year, when a follow-up MRI was obtained and finally at 2 years. The post-MIPSI follow-up MRI at 1 year also demonstrated resolution of the HIZ, with decreased pain (VAS 2/10) and functional improvement. Intradiscal PRP therapy may offer a minimally invasive option for patients with IDD, promoting symptomatic relief and structural healing.