Abstract
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.
Highlights
Platelet-rich plasma (PRP) is blood plasma with concentrated autologous platelets and various growth factors as well as cytokines above the normal baseline level
PRP is believed to contain several growth factors including platelet-derived growth factor (PDGF), transforming growth factor (TGF), insulin-like growth factor (IGF), epidermal growth factor (EGF), epithelial cell growth factor (EGR), and hepatocyte growth factor (HGF). ese growth factors can promote the healing of bone and soft tissues [1,2,3]
Included articles had the following inclusion criteria: (1) studies conducted in humans evaluating spinal fusion; (2) studies comparing the outcome between PRP and control subject; (3) studies evaluating spinal fusion by either radiograph or computed tomography (CT); (4) the sample size was bigger than 10; (5) only retrospective/prospective studies published in English; and (6) no geographic restriction was set
Summary
Platelet-rich plasma (PRP) is blood plasma with concentrated autologous platelets and various growth factors as well as cytokines above the normal baseline level. The use of PRP to augment bone fusion after spinal deformity correction in humans is still controversial; Kubota et al [9] in their prospective randomized control trial of posterolateral lumbar fusion surgery found a high fusion rate in the PRP group compared to control. 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. E 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). PRP stimulatory effects are not continuous and are very effective within six months of implantation
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
