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

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243204
Author(s):  
Ying-feng Cai ◽  
Tian-Zhao Tian ◽  
Li-Ye Chen ◽  
Bao-Xin Liu ◽  
Jian-Peng Zhou ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Cohort Studies ◽  
Spinal Fusion ◽  
Complication Rate ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Clinical Results ◽  
Fusion Rate ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery

Background Platelet-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/Purposes 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. Patients and methods Studies comparing PRP to non-PRP treatment with respect to the fusion rate and clinical outcome in patients who underwent spinal fusion surgery were included. Result Three 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. Conclusion According 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.

scholarly journals Postoperative bisphosphonate do not significantly alter the fusion rate after lumbar spinal fusion: a meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jun Mei ◽  
Xiaoxu Song ◽  
Xiaoming Guan ◽  
Dou Wu ◽  
Junjie Wang ◽  
...  
Keyword(s):  
Bone Formation ◽  
Spinal Fusion ◽  
Meta Analysis ◽  
Fusion Rate ◽  
Lumbar Spinal Fusion ◽  
Fusion Surgery ◽  
Number Of Patients ◽  
Cage Subsidence ◽  
Lumbar Spinal

Abstract Background To evaluate the effect of postoperative BP treatment on improving the fusion rate after lumbar spinal fusion surgery by performing a meta-analysis of randomized controlled trials (RCTs) and other comparative cohort studies. Methods A comprehensive search of PubMed, EMBASE, the Web of Science, and the Cochrane Central Register of Controlled Trials was performed for RCTs and other comparative cohort studies on the effect of BP treatment on improving the fusion rate after lumbar spinal fusion surgery. The primary outcome measures were the number of patients with bone formation grades A, B, and C at 12 months of follow-up; fusion rates at 12 and 24 months of follow-up; vertebral compression fracture (VCF) at 12 and 24 months of follow-up; pedicle screw loosening at 24 months of follow-up; and cage subsidence, the Oswestry disability index (ODI), and the visual analogue score (VAS) at 12 months of follow-up. The final search was performed in July 2020. Results Seven studies with 401 patients were included. Compared with the placebo, BP treatment did not significantly alter the number of patients with bone formation grades A, B, and C, or the VAS at the 12-month follow-up or the fusion rates at the 12- and 24-month follow-ups. In addition, compared with the placebo, BPs significantly reduced the risks of VCF at the 12- and 24-month follow-ups, pedicle screw loosening at the 24-month follow-up, and cage subsidence and the ODI at the 12-month follow-up. Conclusions Postoperative BPs do not clearly improve bone formation and the fusion rate, but they reduce VCF, cage subsidence, and loosening of pedicle screws after lumbar fusion surgery compared with the control treatment.

scholarly journals Safety and Tolerability of Stromal Vascular Fraction Combined with β-Tricalcium Phosphate in Posterior Lumbar Interbody Fusion: Phase I Clinical Trial

Cells ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 2250
Author(s):  
Kyoung-Tae Kim ◽  
Kwang Gi Kim ◽  
Un Yong Choi ◽  
Sang Heon Lim ◽  
Young Jae Kim ◽  
...  
Keyword(s):  
Spinal Fusion ◽  
Stromal Vascular Fraction ◽  
Posterior Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Control Group ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery ◽  
Combined Use ◽  
Cage Subsidence ◽  
The Right

The rates of pseudarthrosis remain high despite recent advances in bone graft substitutes for spinal fusion surgery. The aim of this single center, non-randomized, open-label clinical trial was to determine the feasibility of combined use of stromal vascular fraction (SVF) and β-tricalcium phosphate (β-TCP) for patients who require posterior lumbar interbody fusion (PLIF) and pedicle screw fixation. Two polyetheretherketone (PEEK) cages were inserted into the intervertebral space following complete removal of the intervertebral disc. The PEEK cage (SVF group) on the right side of the patient was filled with β-TCP in combination with SVF, and the cage on the left side (control group) was filled with β-TCP alone. Fusion rate and cage subsidence were assessed by lumbar spine X-ray and CT at 6 and 12 months postoperatively. At the 6-month follow-up, 54.5% of the SVF group (right-sided cages) and 18.2% of the control group (left-sided cages) had radiologic evidence of bone fusion (p = 0.151). The 12-month fusion rate of the right-sided cages was 100%, while that of the left-sided cages was 91.6% (p = 0.755). Cage subsidence was not observed. Perioperative combined use of SVF with β-TCP is feasible and safe in patients who require spinal fusion surgery, and it has the potential to increase the early bone fusion rate following spinal fusion surgery.

scholarly journals Surgical and Clinical Results of Minimally Invasive Spinal Fusion Surgery in an Unselected Patient Cohort of a Spinal Care Unit

2018 ◽  
Vol 10 (3) ◽  
pp. 192-197 ◽  
Author(s):  
Wolfgang Senker ◽  
Andreas Gruber ◽  
Matthias Gmeiner ◽  
Harald Stefanits ◽  
Kirsten Sander ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Spinal Fusion ◽  
Clinical Results ◽  
Fusion Surgery ◽  
Patient Cohort ◽  
Spinal Fusion Surgery ◽  
Unselected Patient

scholarly journals Accuracy of Pedicle Screw Placement Methods in Pediatrics and Adolescents Spinal Surgery: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 219256822110035
Author(s):  
Brigita De Vega ◽  
Aida Ribera Navarro ◽  
Alexander Gibson ◽  
Deepak M. Kalaskar
Keyword(s):  
Systematic Review ◽  
Spinal Fusion ◽  
Pedicle Screw ◽  
Meta Analysis ◽  
Three Dimensional ◽  
Bias Assessment ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery ◽  
Evidence Quality ◽  
Comprehensive Search

Study Design: Systematic review and meta-analysis. Objective: Various methods of pedicle screw (PS) placement in spinal fusion surgery existed, which can be grouped into conventional freehand (FH), modified freehand (MF), and image-guided methods (including fluoroscopy-based navigation (FL), computed tomography-based navigation (CT-nav), robot-assisted (RA), and ultrasound-guided (UG)). However, the literature showed mixed findings regarding their accuracy and complications. This review aimed to discover which method of PS placement has the highest accuracy and lowest complication rate in pediatric and adolescent spinal fusion surgery. Methods: A comprehensive search in MEDLINE (PubMed), EMBASE (OVID), CENTRAL, and Web of Science was conducted until May 2020 by 2 independent reviewers, followed by bias assessment with ROB 2 and ROBINS-I tools and quantification with meta-analysis. Overall evidence quality was determined with GRADE tool. Results: Four RCTs and 2 quasi-RCTs/CCTs comprising 3,830 PS placed in 291 patients (4-22 years old) were analyzed. The lowest accuracy was found in FH (78.35%) while the highest accuracy was found in MF (95.86%). MF was more accurate than FH (OR 3.34 (95% CI, 2.33-4.79), P < .00 001, I2 = 0%). Three-dimensional printed drill template (as part of MF) was more accurate than FH (OR 3.10 (95% CI, 1.98-4.86), P < .00 001, I2 = 14%). Overall, complications occurred in 5.84% of the patients with 0.34% revision rate. Complication events in MF was lower compared to FH (OR 0.47 (95% CI, 0.10-2.15), P = .33, I2 = 0%). Conclusions: Meta-analysis shows that MF is more accurate than FH in pediatric and adolescent requiring PS placement for spinal fusion surgery.

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