A prospective study of Autologous Growth Factors (AGF) in lumbar interbody fusion

Jenis, Louis G.; Banco, Robert; Kwon, Brian K.

doi:10.1016/j.spinee.2005.08.014

Cited by 85 publications

(69 citation statements)

References 34 publications

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“…The clinical experience is even more contradictory. Its use in intersomatic arthrodesis shows similar results between autograft or allograft plus autologous platelet concentrate [14]. When the analysis of the cage filled with autograft (with or without autologous platelet concentrate) was made by CT, it was observed a quicker fusion in those patients with autologous platelet concentrate added, although the result, at the end of the follow-up, was the same [12].…”

Section: Discussionmentioning

confidence: 83%

Evaluation of autologous platelet concentrate for intertransverse lumbar fusion

et al. 2011

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Introduction The aim of the study was to analyze if the adding of autologous platelet concentrate (APC) to a mixture of local autograft plus tricalcium phosphate and hidroxiapatite (TCP/HA) would improve the fusion rate in posterolateral lumbar fusion. Materials and methods A prospective, controlled, blinded, non-randomized clinical trial was carried out in 107 patients affected by degenerative lumbar pathology. The study group consisted of 67 patients, in which autologous platelet concentration was added to a mixture of autologous local bone graft and TCP/HA. A control group of 40 patients with same pathology and surgical technique but without APC addition was used to compare the fusion mass obtained. By means of plain X-rays, a blinded evaluation of the intertransverse fusion mass quality at twelve and twenty-four months was made according to type A (bilateral uniform mass), type B (unilateral uniform mass) and type C (irregular or lack bilateral mass). Patients with type C were regarded as pseudoarthrosis. ResultsIn the study group 17 patients had lack or irregular fusion mass (25.4%) versus three patients in the control group (7.5%), which was statistically significant. ConclusionsThis study shows that the adding of autologous platelet concentration to a mixture of autologous bone graft plus TCP/HA has decreased our rates of posterolateral lumbar fusion.

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Section: Discussionmentioning

confidence: 83%

Evaluation of autologous platelet concentrate for intertransverse lumbar fusion

et al. 2011

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“…The possible inhibitory effect was studied by Jenis in a prospective non-randomised study, comparing iliac crest bone graft to allograft combined with AGF [21]. Arthrodesis was diagnosed on X-ray and CT-scan.…”

Section: Discussionmentioning

confidence: 99%

“…Several centrifugation techniques have been described for the development of platelet concentrates for clinical use in a wide array of indications [15,19,21,22,39]. Advanced ultrafiltration techniques result in concentrated plasma of up to 10 times that of whole blood: AGF (autologous growth factors).…”

Section: Introductionmentioning

confidence: 99%

Platelet-rich plasma in mono-segmental posterior lumbar interbody fusion

et al. 2011

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Introduction The results of platelet-rich plasma (PRP) in spinal fusion applications are limited and controversial. Both beneficial and inhibitory effects have been shown. In this prospective randomised controlled trial, our objective was to assess both the clinical and radiologicaleffect of PRP when added to autograft iliac crest bone in posterior lumbar interbody fusion. Methods and materials Forty patients were recruited for the study fulfilling strict entry requirements and were randomised with a 1:1 ratio. In each group, one patient was lost to follow-up. Thirtyeight patients completed the Visual Analogue Scale (VAS), the Oswestry Disability Index (ODI), and the Short-Form 36 (SF-36) preoperatively and postoperatively at 3, 6, 12, and 24 months, respectively. CT-scans of the lumbar spine were taken at 3, 6, and 12 months. Posterior stabilisation was achieved with pedicle screws and interbody fusion was aimed at with carbon cages filled with autologous bone. Results Baseline demographic data (age, sex, smoking history, preoperative outcome measures) showed no relevant difference between groups. For patients who received autograft only, the mean VAS improved by 4.0 points (p \ 0.01), mean ODI improved by 32.1 points (p \ 0.001), and mean SF-36 showed statistically significant improvement in each of the eight domains and in the physical (p \ 0.001) and mental (p \ 0.001) component summary measures. For patients who received autograft with PRP, the mean VAS improved by 4.92 points (p \ 0.01), mean ODI improved by 30 points (p \ 0.001), and mean SF-36 showed statistically significant improvement in six of the eight domains (p \ 0.02) and in the physical (p = 0.016) and mental (p \ 0.001) component summary measures. The improvement of the VAS score and the physical component summary score was more pronounced in patients who received autograft with PRP. These differences were, however, not statistically significant. CT-scans showed uneventful osseous healing in all but one patient with no difference between groups. Conclusion In this prospective randomised controlled clinical and radiological trial, adding PRP in posterior lumbar interbody fusion did not lead to a substantial improvement or deterioration when compared with autologous bone only. No inhibitory effect of PRP was observed on CT-scans. From a clinical and radiological point of view, the use of PRP seems to be justified in posterior lumbar interbody fusion surgery. From an economical point of view, the expense of using PRP cannot be justified until statistical significance can be reached in a larger study.

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“…In 2005, Jenis et al [14] described a study in which 37 consecutive patients were submitted to anterior-posterior lumbar interbody fusion (ALIF-PLIF) with bone graft harvested from the iliac crest (22 patients) or allograft combined with AGF (15 patients). Patients were evaluated at 6 and 12 months by CT scan and at 24 months by plain X-rays.…”

Section: Discussionmentioning

confidence: 99%

The use of platelet gel in postero-lateral fusion: preliminary results in a series of 14 cases

et al. 2011

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Over the last few years, some hemocomponents have been used advantageously in clinical neurosurgical practice, not systemically via transfusion but topically as a sealant (fibrin glue). This has diverted the attention of many authors to the role of platelets in the healing process. The combination of hyper-concentrated platelets and fibrin glue (fibrinogen, XIII factor, fibronectin) with activated

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A prospective study of Autologous Growth Factors (AGF) in lumbar interbody fusion

Cited by 85 publications

References 34 publications

Evaluation of autologous platelet concentrate for intertransverse lumbar fusion

Evaluation of autologous platelet concentrate for intertransverse lumbar fusion

Platelet-rich plasma in mono-segmental posterior lumbar interbody fusion

The use of platelet gel in postero-lateral fusion: preliminary results in a series of 14 cases

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