The impact of platelet-rich plasma on postoperative outcomes after spinal fusion : a systematic review and meta-analysis

OBJECTIVE: Platelet-rich plasma (PRP) is a biological agent obtained by centrifuging a sample of blood and retrieving a high concentration of platelets and plasma components. The concentrate is then stimulated for platelet secretion of various growth factors and cytokines. Although it is not widely used in clinical practice, its role in augmenting bony union among patients undergoing spinal fusion has been assessed in several clinical studies. The objective of this study was to perform a systematic review and meta-analysis of the existing literature to determine the efficacy of PRP use in spinal fusion procedures.

METHODS: A comprehensive literature search was conducted using PubMed, Scopus, and EMBASE for studies from all available dates. From eligible studies, data regarding the fusion rate and method of assessing fusion, estimated blood loss (EBL), and baseline and final visual analog scale (VAS) scores were collected as the primary outcomes of interest. Patients were grouped by those undergoing spinal fusion with PRP and bone graft (PRP group) and those only with bone graft (graft-only group).

RESULTS: The literature search resulted in 207 articles. Forty-five full-text articles were screened, of which 11 studies were included, resulting in a meta-analysis including 741 patients. Patients without PRP were more likely to have a successful fusion at the last follow-up compared with those with PRP in their bone grafts (OR 0.53, 95% CI 0.34-0.84; p = 0.006). There was no statistically significant difference with regard to change in VAS scores (OR 0.00, 95% CI -2.84 to 2.84; p > 0.99) or change in EBL (OR 3.67, 95% CI -67.13-74.48; p = 0.92) between the groups.

CONCLUSIONS: This study found that the additional use of PRP was not associated with any significant improvement in patient-reported outcomes and was actually found to be associated with lower fusion rates compared with standard grafting techniques. Thus, PRP may have a limited role in augmenting spinal fusion.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - year:2020

Enthalten in:

Journal of neurosurgery. Spine - (2020) vom: 22. Mai, Seite 1-8

Sprache:

Englisch

Beteiligte Personen:

Yolcu, Yagiz Ugur [VerfasserIn]
Wahood, Waseem [VerfasserIn]
Eissa, Abdullah T [VerfasserIn]
Alvi, Mohammed Ali [VerfasserIn]
Freedman, Brett A [VerfasserIn]
Elder, Benjamin D [VerfasserIn]
Bydon, Mohamad [VerfasserIn]

Links:

Volltext

Themen:

Autograft
Bony union augmentation
EBL = estimated blood loss
GRADE = Grading of Recommendations Assessment, Development and Evaluation
Journal Article
MD = mean difference
NOS = Newcastle-Ottawa Scale
PRP
PRP = platelet-rich plasma
Platelet-rich plasma
RCT = randomized controlled trial
Review
VAS = visual analog scale

Anmerkungen:

Date Revised 27.02.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.3171/2020.3.SPINE2046

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM310252113