Influence of platelet-rich plasma on the anterior fusion in spinal injuries: a qualitative and quantitative analysis using computer tomography

Abstract

The additional application of autologous PRP involves very little risk for the patients. The study implies that the use of PRP provides a faster fusion and higher density values within the fusion mass. A clear advancement in spinal fusion in terms of a clinical benefit remains questionable.

Comparison of Platelet-Rich Plasma and VEGF-Transfected Mesenchymal Stem Cells on Vascularization and Bone Formation in a Critical-Size Bone Defect

“…Recently there have been conflicting reports about the effect of PRP plasma, and there is no consensus regarding the role of PRP in bone regeneration: there are multiple favorable results of PRP regarding the improvement of proliferation of MSC in vitro and in vivo after ectopic implantation, but also in animal models with critical-size bone defects [Kasten et al, 2008b;Bi et al, 2010;Hakimi et al, 2010;Hartmann et al, 2010;Jungbluth et al, 2010;Niemeyer et al, 2010;Bae et al, 2011;Liu et al, 2011]. However, there is also a relevant number of studies reporting no or minimal effects of PRP on bone formation [Li et al, 2004;Roldan et al, 2004;Plachokova et al, 2007;Thor et al, 2007;Vasconcelos Gurgel et al, 2007;You et al, 2007;Miloro et al, 2010;Kazakos et al, 2011].…”

“…Regarding its clinical use in maxillofacial surgery, a recent metaanalysis indicated that there was sufficient evidence to support the use of PRP for bone formation on a sinus bone graft, whereas there was no significant effect on the implant survival and bone-to-implant contact [Bae et al, 2011]. In orthopedic surgery, some authors report positive outcomes in leg lengthening procedures and spinal fusions [Bi et al, 2010;Hartmann et al, 2010]. In summary, the role of PRP remains controversial.…”

Evaluation of autologous platelet concentrate for intertransverse lumbar fusion

“…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]. 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].…”

Is Minimally Invasive Spine Surgery Also Minimally Pro-Inflammatory? Muscular Markers, Inflammatory Parameters and Cytokines to Quantify the Operative Invasiveness Assessment in Spine Fusion

“…In particular, platelets play an active role by producing several pro-and anti-inflammatory mediators, including cytokines (TGF-~, IL-l~, CD40L) and chemokines (CXCL-l, -4, -5, -7, -8, -12 CXCL-4Ll, CCl-2, -3, -5), being themselves regulated by the inflammatory response through their chemokine receptors (CCR-l, 3,4, CXCR-4) (71). Dependently from this evidence, spine fusion techniques (74), as well as the whole set of orthopaedic surgeries (75), have been implemented with the use of the platelet-rich plasma (PRP) to improve the healing based on the pro-reparative properties of the platelet content (76). After the activation platelets degranulate releasing the contents of their granules consisting of inflammatory and growth factors (platelet-derived growth factor (PDGF), TGF-a and~, epidermal growth factor (EGF), fibroblast growth factor (FGF) -2, insulin-like growth factor (IGF) and vascular endothelial growth factor (VEGF) (77,78).…”