Efficacy of Platelet-Rich Plasma for Bone Fusion in Transforaminal Lumbar Interbody Fusion.
Efficacy of Platelet-Rich Plasma for Bone Fusion in Transforaminal Lumbar Interbody Fusion.
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DOI：
10.4184/asj.2018.12.1.112
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发表时间：
2018-03
影响因子：
2.3
通讯作者：
Ohtori S
中科院分区：
文献类型：
--
作者：
Kubota G;Kamoda H;Orita S;Inage K;Ito M;Yamashita M;Furuya T;Akazawa T;Shiga Y;Ohtori S
回顾病例系列。目的探讨富含血小板血浆(PRP)在经孔腰椎间融合术(TLIF)中局部植骨的疗效。几位作者已经报道了PRP在动物模型中对骨愈合的疗效。然而，PRP在TLIF手术中用于骨融合的应用还没有得到充分的探索。20例L4滑脱患者接受了单节段TLIF手术。对照组9例采用椎间融合器+局部骨融合器，PRP组11例采用椎间融合器+局部骨+PRP。PRP取自患者手术前即刻的血液样本(400毫升)。分别于术后3个月行X线平片检查，术后12个月或24个月行CT检查，评估骨折愈合时间及术后骨融合率。术前、术后3个月、6个月、12个月和24个月采用视觉模拟评分法评估下腰痛、腿痛和小腿麻木情况。PRP患者的血小板计数是血液的8.7倍。治疗组骨愈合率明显高于对照组(分别为91%和77%，P=0.035)，而骨愈合时间差异无统计学意义(分别为7.70±0.74月和10.0±2.00月，P=0.131)。两组患者在随访期间下腰痛、腿痛和小腿麻木方面差异无统计学意义(p>；0.05)。我们的研究表明，在TLIF手术中使用PRP可以提高植骨融合率。
Retrospective case series. To examine the efficacy of platelet-rich plasma (PRP) for bone fusion in transforaminal lumbar interbody fusion (TLIF) using local bone grafting. Several authors have reported the efficacy of PRP for bone union in animal models. However, the use of PRP for bone fusion in TLIF surgery has not been fully explored. Twenty patients underwent single-level TLIF surgery because of L4 spondylolisthesis. An interbody fusion cage and local bone were used in nine patients (control group) and an interbody fusion cage, local bone, and PRP were used in 11 patients (PRP group). PRP was prepared from the patients' blood samples (400 mL) immediately before surgery. The duration of bone union and postoperative bone fusion rate were assessed using plain radiography at every 3 months postoperatively and computed tomography at 12 or 24 months postoperatively, respectively. Lower back pain, leg pain, and leg numbness were evaluated using the visual analog scale preoperatively and at 3, 6, 12, and 24 months postoperatively. The platelet count was 8.7 times higher in PRP than in blood. The bone union rate was significantly superior in the PRP group than in the control group (91% and 77%, respectively; p=0.035), whereas the average duration of bone union was not significantly different between the groups (7.7±0.74 and 10.0±2.00 months, respectively; p=0.131). There was no significant difference in lower back pain, leg pain, and leg numbness in both groups during follow-up (p>0.05). Our study suggests that the use of PRP in TLIF surgery increases bone fusion rate.