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

Abstract

<jats:sec> <jats:title>Object</jats:title> <jats:p>In a double-blind randomized study, platelet concentrate was used to treat 50 patients who underwent anterior cervical fusion with allograft bone and internal fixation, predominantly for degenerative disc disease or soft herniated cervical disc. The goal in this study was to compare the outcomes in patients treated with and without the platelet gel.</jats:p></jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Patients were assessed radiographically at 6, 12, and 52 weeks and at 2 years if needed. Clinically, patients were evaluated with the visual analog scale, Neck Disability Index, Short Form–36, and a modified Prolo Scale.</jats:p></jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Follow-up included 90% of the patients at 1 year and 84% at 2 years. The overall fusion rate was 84%.</jats:p></jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Whereas patients with degenerative discs treated with platelet gel demonstrated early fusion at the 12-week follow-up interval, no consistent early fusion was obtained with the use of the platelet gel preparation in patients with a soft disc herniation.</jats:p></jats:sec>

Prospective Analysis of Imaging Prediction of Pseudarthrosis After Anterior Cervical Discectomy and Fusion

“…5,10,[17][18][19][20][21][22] Multiple recent studies support, have explored, or have used a 2Њ of motion threshold [17][18][19][20][21][22] ; although, validation of this threshold is limited. Two studies have looked at CT scans and compared them with dynamic radiographs.…”

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

“…For instance, Feiz-Erfan et al 15 performed a prospective randomized trial to compare the effects of structural allografts and PRP to allograft alone in 1-and 2-level ACDFs for degenerative disk disease, and found a faster time to fusion in the PRP group, but no difference in overall fusion rate at 12 months. Similar results were obtained in a cohort-control study comparing 1-, 2-, and 3-level cage reconstructions with autograft and PRP compared to autograft alone.…”

“…1,5,8,9,15,18,19,24,34,37,[54][55][56][57]65 One study utilized an ACDF approach, one study studied posterior cervical fusions, six studies assessed thoracolumbar interbody grafts, and seven studies utilized a lumbar posterolateral fusion approach, including both instrumented and noninstrumented fusions. Most studies utilized commercially available systems for PRP preparation.…”

Bone graft substitutes in anterior cervical discectomy and fusion

“…Feiz-Erfan et al conducted a double-blinded randomized trial for ACF using instrumented allograft with or without platelet-gel concentrate [36]. Platelet-gel showed no evidence of promoting early fusion and achieved no significant difference in arthrodesis rates at 12 months.…”

“…The supplementation of platelet concentrate in grafting is purported to benefit bone healing through provision of osteopromotive growth factors and an osteoconductive fibrin clot meshwork [5,36]. Feiz-Erfan et al conducted a double-blinded randomized trial for ACF using instrumented allograft with or without platelet-gel concentrate [36].…”