Effect of autologous platelet gel on early and late graft fusion in anterior cervical spine surgery

Feiz-Erfan, Iman; Harrigan, Mary; Sonntag, Volker K. H.; Harrington, Timothy

doi:10.3171/spi.2007.7.5.496

Cited by 6 publications

(18 citation statements)

References 29 publications

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“…This was confirmed by stability on for all patients was 15.5; at 2-year follow-up the mean score had improved to 7.0. 24 Similarly, Coric et al 26 showed a >20% improvement in NDI scores at 2-year follow-up. The methods used for assessing patient-reported outcomes were heterogeneous, limiting quantitative analysis of association of allograft interbody with clinical outcomes.…”

Section: Patient-reported Outcomesmentioning

confidence: 91%

“…Seven studies described patient-reported outcomes, with an overall significant improvement in clinical outcomes assessed by VAS and NDI scores. [21][22][23][24][25][26]28 Feiz-Erfan et al 24 reported subjective improvements overall. In VAS scores ranging from 3 to 30, the mean VAS score at baseline Absence of major angular motion (2 ) on flexion/ extension radiographs and <50% lucency at each potential fusion surface.…”

Section: Patient-reported Outcomesmentioning

confidence: 99%

“…In 11 studies, fusion was assessed by an independent or blinded physician. [21][22][23][24][25][26][27][28][29][30][31] Criteria for fusion success differed slightly among studies, although motion (commonly defined as <2 or <4 change in angulation between the spinous processes) on flexion-extension radiographs is the commonly used method to determine fusion success ( Table 2).…”

Section: Fusion Ratesmentioning

confidence: 99%

“…Structural Allograft. Nine studies (1354 patients) reported fusion data with the use of structural allograft: 5 used corticocancellous allograft, 21,24,26,28,31 2 used unspecified cortical allograft, 22,25 1 used fibular allograft, 30 and 1 did not report the type of allograft used. 23 The fusion rates among these 9 studies were 82% to 100%.…”

Section: Fusion Ratesmentioning

confidence: 99%

“…Eleven studies reported patient-reported outcomes, with VAS and NDI being the most frequently used measures. [21][22][23][24][25][26][27][28][29]32,34 Structural Allograft. Seven studies described patient-reported outcomes, with an overall significant improvement in clinical outcomes assessed by VAS and NDI scores.…”

Section: Patient-reported Outcomesmentioning

confidence: 99%

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Structural Allograft Versus PEEK Implants in Anterior Cervical Discectomy and Fusion: A Systematic Review

Jain

Marrache

Harris

et al. 2019

Global Spine Journal

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Study Design: Systematic literature review. Objective: Our primary objective was to compare reported fusion rates after anterior cervical discectomy and fusion (ACDF) using structural allograft versus polyetheretherketone (PEEK) interbody devices in patients with cervical spine degeneration. Our secondary objectives were to compare differences in rates of subsidence and reoperation and in patient-reported outcomes between the 2 groups. Methods: Through a systematic review of the English-language literature using various databases, we identified 4702 articles. After we applied inclusion and exclusion criteria, 14 articles (7 randomized controlled trials, 4 prospective studies, and 3 retrospective studies) reporting fusion rates of structural allograft or PEEK interbody devices were eligible for our analysis. No randomized controlled trials compared outcomes of structural allograft versus PEEK interbody devices. Extracted data included authors, study years, study designs, sample sizes, patient ages, duration of follow-up, types of interbody devices used, fusion rates, definition of fusion, reoperation rates, subsidence rates, and patient-reported outcomes. Results: Fusion rates were 82% to 100% for allograft and 88% to 98% for PEEK interbody devices. The reported data were insufficient to perform meta-analysis. Structural allograft had the highest reported rate of reoperation (14%), and PEEK interbody devices had the highest reported subsidence rate (18%). Patient-reported outcomes improved in both groups. There was insufficient high-quality evidence to compare the associations of various PEEK modifications with fusion rates. Conclusion: Fusion rates were similar between structural allograft and PEEK interbody devices when used for ACDF for cervical spine degeneration. Currently, there is insufficient high-quality evidence to assess associations of PEEK modifications with fusion rates.

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Section: Patient-reported Outcomesmentioning

confidence: 91%

Section: Patient-reported Outcomesmentioning

confidence: 99%

Section: Fusion Ratesmentioning

confidence: 99%

Section: Fusion Ratesmentioning

confidence: 99%

Section: Patient-reported Outcomesmentioning

confidence: 99%

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Structural Allograft Versus PEEK Implants in Anterior Cervical Discectomy and Fusion: A Systematic Review

Jain

Marrache

Harris

et al. 2019

Global Spine Journal

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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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Is Platelet-Rich Plasma Effective in Enhancing Spinal Fusion? Systematic Overview of Overlapping Meta-Analyses

Muthu¹,

Jeyaraman²,

Ganie³

et al. 2021

Global Spine Journal

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Study Design: Systematic review. Objectives: We performed this systematic overview on overlapping meta-analyses that analyzed the role of platelet-rich plasma(PRP) in enhancing spinal fusion and identify which study provides the current best evidence on the topic and generate recommendations for the same. Materials and Methods: We conducted independent and duplicate electronic database searches in PubMed, Web of Science, Embase, Cochrane Database of Systematic Reviews, and Database of Abstracts of Reviews of Effects till October-2020 for meta-analyses that analyzed the role of PRP in spinal fusion procedures. Methodological quality assessment was made using Oxford Levels of Evidence, AMSTAR scoring, and AMSTAR 2 grades. We then utilized the Jadad decision algorithm to identify the study with highest quality to represent the current best evidence to generate recommendations. Results: 3 meta-analyses fulfilling the eligibility criteria were included. The AMSTAR scores of included studies varied from 5-8(mean:6.3) and all included studies had critically low reliability in their summary of results due to their methodological flaws according to AMSTAR 2 grades. The current best evidence showed that utilization of PRP was not associated with significant improvement in patient-reported outcomes such as Visual Analog Score for pain compared to the standard fusion procedure. Moreover, PRP was found to be associated with lower fusion rates. Conclusion: Based on this systematic overview, the effectiveness of PRP as a biological agent in augmenting spinal fusion is limited. Current evidence does not support the use of PRP as an adjuvant to enhance spinal fusion.

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Effect of autologous platelet gel on early and late graft fusion in anterior cervical spine surgery

Cited by 6 publications

References 29 publications

Structural Allograft Versus PEEK Implants in Anterior Cervical Discectomy and Fusion: A Systematic Review

Structural Allograft Versus PEEK Implants in Anterior Cervical Discectomy and Fusion: A Systematic Review

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

Is Platelet-Rich Plasma Effective in Enhancing Spinal Fusion? Systematic Overview of Overlapping Meta-Analyses

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