{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T07:20:27Z","timestamp":1784013627251,"version":"3.55.0"},"reference-count":36,"publisher":"Baishideng Publishing Group Inc.","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Orthop"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n          <jats:p>Chronic inflammatory pain is associated with increased expression of interleukin (IL)-1, an inflammatory cytokine, and activity on its receptor (IL-1R). In response, the body produces IL-1R antagonist (IL-1Ra) to reduce this signaling. Autologous conditioned serum (ACS) is the only biologic therapy for spinal pathologies that enhances the action of endogenous IL-1Ra reserves to improve symptoms. This systematic review investigates the effectiveness of ACS in treating pain and disability caused by spinal pathologies.<\/jats:p>\n          <jats:p>AIM<\/jats:p>\n          <jats:p>To evaluate the use of ACS as a conservative management option for spinal pathology.<\/jats:p>\n          <jats:p>METHODS<\/jats:p>\n          <jats:p>A systematic review of PubMed\/Medline was performed to identify studies investigating administration of ACS for treatment of any spinal pathology.<\/jats:p>\n          <jats:p>RESULTS<\/jats:p>\n          <jats:p>Six articles were included, comprising 684 patients treated with epidural (n  = 133) or transforaminal (n  = 551) ACS injections. Patients had an average age of 54.0 years with slight female predominance (53.2%). The lumbar spine was most commonly treated, with 567 patients (82.9%) receiving injections for lumbar radiculopathy (n  = 67), degenerative disc disease (DDD) (n  = 372), or spinal stenosis (n  = 128); cervical injections were performed in 109 patients (15.9%). Mean (SD) follow-up was 21.7 (4.8) weeks from first ACS injection. All studies investigating mechanical lumbar and lumbar or cervical radicular pain reported significant pain reduction at final follow-up compared to baseline. ACS achieved comparable or superior results to lumbar epidural steroid injections. Adverse events were reported in 21 patients (3.1%), with no serious adverse events.<\/jats:p>\n          <jats:p>CONCLUSION<\/jats:p>\n          <jats:p>ACS injection is a safe and effective intervention for pain reduction in many spinal pathologies, including cervical and lumbar radiculopathies.<\/jats:p>","DOI":"10.5312\/wjo.v15.i9.870","type":"journal-article","created":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T06:30:52Z","timestamp":1726122652000},"page":"870-881","source":"Crossref","is-referenced-by-count":4,"title":["Conservative management of spinal pathology with autologous conditioned serum: A systematic review of the literature"],"prefix":"10.5312","volume":"15","author":[{"given":"Christian J","family":"Rajkovic","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew L","family":"Merckling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa W","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Galadu","family":"Subah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aryan","family":"Malhotra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary D","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina L","family":"Zeller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John V","family":"Wainwright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merritt D","family":"Kinon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2060","published-online":{"date-parts":[[2024,9,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gene.2013.05.069"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neulet.2003.12.007"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2020.543331"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2021.01.014"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200405150-00011"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1084\/jem.159.1.126"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1186\/s41232-019-0101-5"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.2165\/00063030-200721050-00004"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.149.3.1054"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2016.06.003"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2024.06.004"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.2460\/ajvr.68.3.290"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci13050749"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181076514"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000924"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.4184\/asj.2015.9.6.916"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.5604\/01.3001.0014.1167"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.5604\/15093492.1198829"},{"key":"B20","unstructured":"Casiano VE, Sarwan G, Dydyk AM, Varacallo M.   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