The Science and Clinical Applications of Placental Tissues in Spine Surgery

Abstract

Study Design:Narrative literature review.Objectives:Placental tissue, amniotic/chorionic membrane, and umbilical cord have seen a recent expansion in their clinical application in various fields of surgery. It is important for practicing surgeons to know the underlying science, especially as it relates to spine surgery, to understand the rationale and clinical indication, if any, for their usage.Methods:A literature search was performed using PubMed and MEDLINE databases to identify studies reporting the application of placental tissues as it relates to the practicing spine surgeon. Four areas of interest were identified and a comprehensive review was performed of available literature.Results:Clinical application of placental tissue holds promise with regard to treatment of intervertebral disc pathology, preventing epidural fibrosis, spinal dysraphism closure, and spinal cord injury; however, there is an overall paucity of high-quality evidence. As such, evidence-based guidelines for its clinical application are currently unavailable.Conclusions:There is no high-level clinical evidence to support the application of placental tissue for spinal surgery, although it does hold promise for several areas of interest for the practicing spine surgeon. High-quality research is needed to define the clinical effectiveness and indications of placental tissue as it relates to spine surgery.

Repeated Freezing Procedures Preserve Structural and Functional Properties of Amniotic Membrane for Application in Ophthalmology

“…The placenta is a temporary organ with a broad variety of unique physiological functions, as well as a distinctive structure and composition, which represent an immense potential for efficient application in the field of regenerative medicine [1][2][3][4][5][6][7][8][9]. The virtually unlimited availability of placental material along with highly pronounced therapeutic effects in a wide range of clinical cases provide support for the patients for over a century of successful clinical use and promote the further development of novel therapeutic strategies and approaches [3,[8][9][10][11][12][13][14][15]. In the majority of countries, the application of placental components faces no or low ethical issues.…”

The Effect of Amniotic Tissue on Spinal Interventions: A Systematic Review

“…45 More recently, there is early evidence to support its role in the treatment of a number of musculoskeletal pathologies, including the spine. 46 Notwithstanding, clinical research relating to amniotic membrane tissue in spinal surgery remains sparse. However, among the studies included in this analysis, very few complications have been reported suggesting the safety of amnion-derived products incorporated in spine procedures.…”

Future of Bovine Amniotic Membrane: Bovine Membrane Application on Wound Healing, Surgery and Prospect of Use for Urethral Reconstruction

“…While this retrospective pilot study does not prove the superiority of dehydrated amnion over other dural adjuncts, or the efficacy of use, they demonstrate that it has an adequate safety profile with no complications directly related to its use in closures for craniotomies. They also report very low CSF leak rates and infection rates, particularly in craniotomies for infratentorial lesions [70][71][72].…”