Platelet Concentrate In Lumbar Interbody Cage Fusion: A New Era of Modality Of Fusion

Mohamed  Mohi EL din; Ahmed Salah Hassan; Tarek Ahmed Tareef; Mohammad  Baraka; Mohamed  Gabr; Ahmed H. Omar

doi:10.3889/oamjms.2021.6130

Authors

Mohamed Mohi EL din Department of Neurosurgery, Faculty of Medicine, Cairo University, Giza, Egypt https://orcid.org/0000-0002-3659-4985
Ahmed Salah Hassan Department of Neurosurgery, Faculty of Medicine, Cairo University, Giza, Egypt https://orcid.org/0000-0001-6936-0264
Tarek Ahmed Tareef Department of Neurosurgery, Faculty of Medicine, Cairo University, Giza, Egypt
Mohammad Baraka Department of Neurosurgery, Faculty of Medicine, Cairo University, Giza, Egypt https://orcid.org/0000-0002-4009-6946
Mohamed Gabr Department of Neurosurgery, Faculty of Medicine, Cairo University, Giza, Egypt
Ahmed H. Omar Department of Neurosurgery, Faculty of Medicine, Cairo University, Giza, Egypt

DOI:

https://doi.org/10.3889/oamjms.2021.6130

Keywords:

Lumbar spine, Platelet-rich plasma, Platelet-rich fibrin, Transforaminal lumbar interbody fusion

Abstract

AIM: This was a prospective double-blinded randomized comparative study. Several authors have reported the efficacy of platelets derivatives for spinal union. However, the use of PRP and PRF for bone fusion with TLIF has not been fully explored.

METHODS: Standard open TLIF surgery was performed on 80 patients, randomized in three groups, TLIF and local bone were used in 40 patients (control group) and TLIF, local bone, and PRP were used in 20 patients (PRP group) and PRF was used in 20 patients (PRF group). Radiological parameters were assessed by X-ray after 3 months post-operative to evaluate the position of the screws and cage migration and by CT scans at 6 months and 12 months postoperatively. Patients, surgeons, and post-surgical analysis were blinded.

RESULTS: VAS scores for lower back pain and leg pain were statistically significant between the three groups preoperatively. The VAS scores of back pain improved after 12 months and were statistically significant (p < 0.001) and the VAS score of leg pain improved compared with preoperatively in the three groups during the 6- and 12-month follow-up postoperatively, however, the three groups, VAS scores for leg pain were not significantly different. After 1-year follow-up, significantly more patients achieved definite fusion, when implanted platelets derivatives compared with the control group, but with no significance regarding fusion rates.

CONCLUSION: We advocated using platelet derivative as a fusion enhancer modality which is cost and time saving. It appears to be a complementary step that ensures better outcome for the patients.

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