Efficacy of Autologous Growth Factors in Lumbar Intertransverse Fusions

Weiner, Bradley K.; Walker, M.

doi:10.1097/01.brs.0000083141.02027.48

Cited by 120 publications

(90 citation statements)

References 15 publications

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“…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]. It is true some authors emphasize on its goodness for lumbar arthrodesis [4,6] but our results agree with those from literature and we can claim, as a rule, that we get less fusion rates when adding autologous platelet concentrate to autograft or autograft plus TCP/HA [5,17,24,26,30]. So far, all clinical reports are case studies and we did not find level-1 data to support the use of autologous platelet concentrate in spinal fusion [1].…”

Section: Discussionsupporting

confidence: 82%

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: Discussionsupporting

confidence: 82%

Evaluation of autologous platelet concentrate for intertransverse lumbar fusion

et al. 2011

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“…19 PRP has also been used in plantar fasciitis, spinal fusion, and in total knee arthroplasty with varying degrees of success. 4,5,7,11,27 PRP accelerated wound healing of human skin punch wounds in a recent prospective, controlled study. 13 The mechanisms by which PRP may work, however, have not been elucidated.…”

Section: Discussionmentioning

confidence: 99%

“…In some studies, PRP has been shown to decrease spine fusion rates. 7,27 Also, PRP in animal studies inhibits demineralized bone matrixmediated bone formation. 22 PRP may, however, help initiate, enhance, or accelerate soft tissue healing.…”

Section: Introductionmentioning

confidence: 99%

Buffered Platelet-Rich Plasma Enhances Mesenchymal Stem Cell Proliferation and Chondrogenic Differentiation

Mishra

Tummala²,

King

et al. 2009

Tissue Engineering Part C: Methods

359

257

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The success of tissue engineering applications can potentially be dramatically improved with the addition of adjuncts that increase the proliferation and differentiation of progenitor or stem cells. Platelet-rich plasma (PRP) has recently emerged as a potential biologic tool to treat acute and chronic tendon disorders. The regenerative potential of PRP is based on the release of growth factors that occurs with platelet rupture. Its autologous nature gives it a significant advantage in tissue engineering applications. To test whether PRP may be useful specifically for cartilage regeneration, a cell culture experiment was devised in which mesenchymal stem cells (MSCs) were grown in control media or media enhanced with inactivated, buffered PRP. Proliferation 7 days after PRP treatment was increased: 1.041 versus 0.199 for the control media cells ( p < 0.001). The messenger RNA (mRNA) level of the osteogenic marker RUNX2 was 52.84 versus 26.88 for the control group ( p < 0.005). Likewise the mRNA level of the chondrogenic markers Sox-9 and aggrecan was 29.74 versus 2.29 for the control group ( p < 0.001) and 21.04 versus 1.93 ( p < 0.001), respectively. These results confirm that PRP enhances MSC proliferation and suggest that PRP causes chondrogenic differentiation of MSC in vitro.

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“…The AGF is a modified hemoconcentrator that requires PRP be prepared using a cell salvage device for further PRP concentration. Nevertheless, in some papers, the effect of applying concentrated PRP to tissues to increase growth factor delivery revealed no effect (Lowery et al 1999, Weiner and Walker 2003, Castro 2004, Carreon et al 2005. To account for the device differences in preparation volume, and therefore PRP volume, we calculated the total amount of growth factors rather than measuring the individual concentrations of PDGF-AB and TGF-b.…”

Section: Discussionmentioning

confidence: 99%