A Systematic Assessment of the Use of Platelet-Rich Plasma in Spinal Fusion

Elder, Benjamin D.; Holmes, Christina; Goodwin, C. Rory; Lo, Sheng Fu L.; Puvanesarajah, Varun; Kosztowski, Thomas; Locke, John; Witham, Timothy F.

doi:10.1007/s10439-015-1300-0

Cited by 19 publications

(13 citation statements)

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“…First is a ''separation" step, in which the red blood cells are separated out from the plasma and platelets through centrifugation. The plasma and platelet layers are then removed and a second centrifugation step, the ''concentration" step, is performed to extract a platelet pellet [15]. The PRP preparation methods in the included studies varied ( Table 2).…”

Section: Literature Searchmentioning

confidence: 99%

The effect of platelet-rich plasma on the fusion rate and clinical outcome of spinal fusion surgery: A systematic review and meta-analysis

et al. 2020

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Background Platelet-rich plasma (PRP) is widely used in many orthopedic surgeries and spinal disease treatments; however, the effect of PRP on spinal fusion remains controversial. Questions/Purposes To assess the fusion rate and clinical results of PRP compared with non-PRP administration in the treatment of spinal fusion with regard to decreasing pain and improving healing and function. Patients and methods Studies comparing PRP to non-PRP treatment with respect to the fusion rate and clinical outcome in patients who underwent spinal fusion surgery were included. Result Three randomized controlled trials (RCTs) and 7 prospective cohort studies were identified. The spinal fusion rate was not significantly different between the groups in all RCTs or cohort studies at the final follow-up. In comparison, PRP significantly reduced pain after surgery as evaluated in the RCT analysis and the complication rate did not differ significantly between the two groups. Conclusion According to the available studies, PRP does not contribute to the union rate, relieve pain or increase the complication rate in spinal fusion surgery. As clinical heterogeneity exists in these studies, further large, well-designed RCTs that focus on the standard assessment of PRP are needed.

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Section: Literature Searchmentioning

confidence: 99%

The effect of platelet-rich plasma on the fusion rate and clinical outcome of spinal fusion surgery: A systematic review and meta-analysis

et al. 2020

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“…PRP is believed to contain several growth factors including platelet-derived growth factor (PDGF), transforming growth factor (TGF), insulin-like growth factor (IGF), epidermal growth factor (EGF), epithelial cell growth factor (EGR), and hepatocyte growth factor (HGF). ese growth factors can promote the healing of bone and soft tissues [1][2][3]. Spinal fusion is a commonly performed procedure in the treatment of spinal instability due to different spinal pathologies.…”

Section: Introductionmentioning

confidence: 99%

Role of Platelet-Rich Plasma in Spinal Fusion Surgery: Systematic Review and Meta-Analysis

Manini

Shega

Guo

et al. 2020

Advances in Orthopedics

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Background. Platelet-rich plasma (PRP) has been used very successfully in enhancing bone fusion in animal experiments. Also, the efficaciousness of PRP in other specialties of medicine such as dentistry, dermatology ophthalmology, and sports medicine is well documented. But the use of PRP to augment bone fusion after spinal surgery in humans is still controversial. We conducted a meta-analysis to determine the role of PRP in enhancing spinal fusion by fastening the rate of new bone formation and decreasing pain after spinal surgery in humans. Methods. We searched PubMed, EMBASE, and the Cochrane Library studies that compared PRP versus control in enhancing spinal fusion after deformity correction. Results. Five retrospective studies with 253 participants and nine prospective cohort studies with 460 participants were identified. The bone fusion rate was excellent for studies that used a high platelet concentration in PRP relative to control (odds ratio (OR) = 4.35, 95% confidence interval (CI) (2.13, 8.83), and P<0.05) while bone fusion was poor to studies that used a low concentrate of platelet in PRP relative to control. The rate of new bone formation was high in the PRP group compared to the control group with the mean difference in Hounsfield unit (HU) 144.91 (95% CI (80.63, 209.18), P<0.05). Time to bone fusion was short in the PRP group during the first six months of surgery relative to the control group with a mean difference of −2.03 (95% CI (−2.35, −1.7); P<0.05). No difference was found in pain reduction by visual analog score (VAS) between the PRP group and control. Conclusion. PRP facilitates new bone formation and bone fusion with a minimum concentration of the growth factor 5 times that of the peripheral blood. PRP stimulatory effects are not continuous and are very effective within six months of implantation.

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“…Changes in bone and cartilage tissues under the influence of PRP [5; 6] are also commonly associated with the factors such as TGF-β, IGF, FGFb, PDGF [7; 8; 9; 10]. In this case, the role of ADP (adenosine di-phosphate) and ATP (adenosine triphosphate), and fibronectin has been established in remodeling and regeneration of bone tissue; and the role of angiopoietin-2, vascular endothelial growth factors, thrombospondin-1 was shown in the processes of bone tissue vascularization [11].…”

Section: Introductionmentioning

confidence: 99%

“…The influence of platelet concentration in PRP on chondrogenesis and osteogenesis has been observed. Thus, the degree of bone regeneration at low concentrations was minimal, and with excessively high concentrations there was inhibition of bone tissue regeneration [11]. Also the data were obtained demonstrating the dose-dependent action of PRP anabolic effect on the nucleus pulposus cells of animal intervertebral disc in culture: increased viability [26], increased proliferation of chondrocytes [17; 18], prevention of reduction of chondrogenic genes expression [26].…”

Section: Introductionmentioning

confidence: 99%

“…еt al. (2015) was the first to systematize the results of 15 clinical trials on PRP use in the anterior cervical discectomy with spondylosyndesis, posterior cervical stabilization, thoracolumbar stabilization, posterior-lateral lumbar stabilization (with or without instrumentation), in which the quality of the intervertebral fusion was evaluated according to static and functional radiography and CT [11]. The authors emphasize the possibility of dependence between the results of studies and concentrations of platelets and biologically active substances contained therein, which has been proved experimentally.…”

Section: Introductionmentioning

confidence: 99%

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The Results of Autotransfusion With Platelet Rich Plasma in Spinal Neurosurgery

Pedachenko¹

2018

Ž. klìn. eksp. med. dosl.

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THE RESULTS OF AUTOTRANSFUSION WITH PLATELET RICH PLASMA IN SPINAL NEUROSURGERY. Introduction. Рlatelet-rich plasma (PRP), a blood plasma separated by centrifugation with highly abundant platelets, has multiple applications in many healthcare fields for the improvement of soft and bone tissues regeneration. The studies of PRP implementation results in spine neurosurgery are of high demand in case of pathologies related to the degeneration or injury of living bone and cartilaginous elements of vertebral column, which require the installation of vertebral interbody fusion system. Purpose. Improvement of surgical treatment outcomes by means of improving postoperative wound healing and reducing pain severity after the installation of transpedicular fixation systems in the lumbar spine using a biotechnological method which has a multimodal effect on regeneration processes and is simple and cost-effective Materials and Methods. The results of transpedicular stabilization in lumbar spine vertebral column were assessed within the early postoperational period in two groups of patients comparable in age and health status with spondylolisthesis and spinal motion segment instability. Patients from the main group (n = 20, average age 47.8 ± 6.6 years) received PRP during the operation as compared to the control one (n = 30, average age 46.9 ± 5.6 years) without PRP injections. Results. It was found that during the first day post-operation the pain severity in the main group was significantly reduced (1.6 ± 0.7 points according to the visual analogous scale) as compared to the control (3.8 ± 0.9 points). Moreover, these characteristics before the discharge of the patients were 0.3 ± 0.3 and 2.0 ± 0.4 points respectively. It is noteworthy that the swelling and wound edges hyperemia were remarkably reduced after the PRP use. Finally, no complications, side-effect or systemic consequences of PRP were observed. Conclusions. Therefore, the local injections of PRP during the installment of transpedicular stabilization system in lumbar spine is easyto-handle and safe approach favoring the quick recovery in early postoperational period.

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A Systematic Assessment of the Use of Platelet-Rich Plasma in Spinal Fusion

Cited by 19 publications

References 67 publications

The effect of platelet-rich plasma on the fusion rate and clinical outcome of spinal fusion surgery: A systematic review and meta-analysis

The effect of platelet-rich plasma on the fusion rate and clinical outcome of spinal fusion surgery: A systematic review and meta-analysis

Role of Platelet-Rich Plasma in Spinal Fusion Surgery: Systematic Review and Meta-Analysis

The Results of Autotransfusion With Platelet Rich Plasma in Spinal Neurosurgery

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