The effect of platelet-rich plasma on the fusion rate and clinical outcome of spinal fusion surgery: A systematic review and meta-analysis.

Ying-Feng Cai,Tian-Zhao Tian,Jian-Peng Zhou,Li-Ye Chen,Hao-Dong Liang,Bao-Xin Liu,Min Shi,Adolfo Maria Tambella

doi:10.1371/journal.pone.0243204

Ying-Feng Cai, Tian-Zhao Tian + Show 6 more

Open Access

https://doi.org/10.1371/journal.pone.0243204

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Journal: PloS one	Publication Date: Dec 3, 2020
Citations: 4	License type: CC BY 4.0

Affiliation: Guangzhou Medical University

Abstract

BackgroundPlatelet-rich plasma (PRP) is widely used in many orthopedic surgeries and spinal disease treatments; however, the effect of PRP on spinal fusion remains controversial.Questions/PurposesTo assess the fusion rate and clinical results of PRP compared with non-PRP administration in the treatment of spinal fusion with regard to decreasing pain and improving healing and function.Patients and methodsStudies comparing PRP to non-PRP treatment with respect to the fusion rate and clinical outcome in patients who underwent spinal fusion surgery were included.ResultThree randomized controlled trials (RCTs) and 7 prospective cohort studies were identified. The spinal fusion rate was not significantly different between the groups in all RCTs or cohort studies at the final follow-up. In comparison, PRP significantly reduced pain after surgery as evaluated in the RCT analysis and the complication rate did not differ significantly between the two groups.ConclusionAccording to the available studies, PRP does not contribute to the union rate, relieve pain or increase the complication rate in spinal fusion surgery. As clinical heterogeneity exists in these studies, further large, well-designed RCTs that focus on the standard assessment of PRP are needed.

Highlights

Spinal fusion is an effective treatment method for spinal diseases, such as disc herniation, spinal instability and degenerative spinal diseases
As clinical heterogeneity exists in these studies, further large, well-designed randomized controlled trials (RCTs) that focus on the standard assessment of platelet-rich plasma (PRP) are needed
Inclusion criteria were defined before the search process, and are listed as follows: (1) patients with degenerative disc diseases, lumbar disc herniation, spinal instability and other spinal diseases who were scheduled for spinal fusion; (2) RCTs and cohort studies comparing PRP with non-PRP; and (3) primary outcomes that include fusion rate and adverse events related to PRP and the visual analog scale (VAS)

Summary

Introduction

Spinal fusion is an effective treatment method for spinal diseases, such as disc herniation, spinal instability and degenerative spinal diseases. Studies have reported 5%-43% nonunion and pseudarthrosis after spinal fusion surgery [1, 2], which can lead to poor clinical outcomes and increase the economic burden of patients. Treatment with platelet-rich plasma (PRP) is a promising strategy that uses a small amount of plasma containing a high concentration of platelets and osteoinductive autologous growth factors and has been reported to help the regeneration of bone and tissue. Studies have shown the efficacy of accelerating bone union and spinal fusion in vivo and in vitro. Platelet-rich plasma (PRP) is widely used in many orthopedic surgeries and spinal disease treatments; the effect of PRP on spinal fusion remains controversial. To assess the fusion rate and clinical results of PRP compared with non-PRP administration in the treatment of spinal fusion with regard to decreasing pain and improving healing and function

Methods

Results

Conclusion