Evaluation of the effectiveness of platelet-rich plasma in the bone consolidation of patients submitted to lumbar arthrodesis☆

Rezende, Caroline Ferraz; Azevedo, Danielly de Paula; Lourenço, Rafael Burgomeister; Duarte, José Fernando; Cardoso, Igor Machado; Jacob, Charbel

doi:10.1016/j.rboe.2017.10.006

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Sumário

ORIGINAL ARTICLE • Rev. bras. ortop. 52 (06) • Nov-Dec 2017 • https://doi.org/10.1016/j.rboe.2017.10.006 copy

Evaluation of the effectiveness of platelet-rich plasma in the bone consolidation of patients submitted to lumbar arthrodesis^☆ ☆ Study conducted at the Hospital Santa Casa de Misericórdia de Vitória, Grupo de Coluna Vertebral, Vitória, ES, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE:

To determine whether the use of autograft associated with platelet-rich plasma (PRP) increases bone healing in patients undergoing lumbar fusion.

METHOD:

This was a prospective, descriptive, and comparative study, which included 40 patients undergoing lumbar fusion, who were divided into two groups: group I, autograft only, and group II, autograft associated with PRP. After surgery, patients were followed-up on the first, third, and sixth month. The Molinari radiographic classification and Glassman tomographic classification were used as criteria to analyze the bone consolidation.

RESULT:

Comparing the group I with group II, according to the criteria of Molinari, bilateral fusion was observed in 27.5% of the patients in group I in the first month after surgery. In group II, the rate of bilateral fusion was 25.0% and 20% in the third and sixth months, respectively. The results of computed tomography scans performed at six months after surgery indicated, according to the criteria of Glassman, a rate of bilateral solid fusion of 15.0% and 10.0% in groups I and II, respectively.

CONCLUSION:

The use of PRP showed no significant difference in bone healing in cases of lumbar arthrodesis.

Keywords:
Low back pain; Arthrodesis; Plasma

Grade	Description
I	Bilateral fusion with presence of the trabeculae in the transverse process
II	Unilateral fusion, with difficulty to visualize the other side
III	Suspected radiolucency or defect in the fusion area
IV	Reabsorption of the graft with instrumentation fatigue

Grade	Description
I	Absence of fusion
II	Partial unilateral fusion
III	Partial bilateral fusion
IV	Solid unilateral fusion
V	Solid bilateral fusion

	Group I	Group II	Total
Molinari – first month
Bilateral fusion
Number	11	9	20
% of the total	27.5%	22.5%	50.0%
Unilateral fusion
Number	5	4	9
% of the total	12.5%	10.0%	22.5%
Defect in the fusion area
Number	2	5	7
% of the total	5.0%	12.5%	17.5%
Graft resorption
Number	2	2	4
% of the total	5.0%	5.0%	10.0%

Total
Number	20	20	40
% of the total	50.0%	50.0%	100.0%

	Group I	Group II	Total
Molinari – third month
Bilateral fusion
Number	8	10	18
% of the total	20.0%	25.0%	45.0%
Unilateral fusion
Number	7	3	10
% of the total	17.5%	7.5%	25.0%
Defect in the fusion area
Number	3	4	7
% of the total	7.5%	10.0%	17.5%
Graft resorption
Number	2	3	5
% of the total	5.0%	7.5%	12.5%

Total
Number	20	20	40
% of the total	50.0%	50.0%	100.0%

	Group I	Group II	Total
Molinari – sixth month
Bilateral fusion
Number	6	8	14
% of the total	15.0%	20.0%	35.0%
Unilateral fusion
Number	7	2	9
% of the total	17.5%	5.0%	22.5%
Defect in the fusion area
Number	5	7	12
% of the total	12.5%	17.5%	30.0%
Graft resorption
Number	2	3	5
% of the total	5.0%	7.5%	12.5%
Total
Number	20	20	40
% of the total	50.0%	50.0%	100.0%

	Group I	Group II	Total
Glassman
Absence of fusion
Number	0	2	2
% of the total	0.0%	5.0%	5.0%
Partial unilateral fusion
Number	3	2	5
% of the total	7.5%	5.0%	12.5%
Partial bilateral fusion
Number	6	4	10
% of the total	15.0%	10.0%	25.0%
Solid unilateral fusion
Number	5	8	13
% of the total	12.5%	20.0%	32.5%
Solid bilateral fusion
Number	6	4	10
% of the total	15.0%	10.0%	25.0%

Total
Number	20	20	40
% of the total	50.0%	50.0%	100.0%

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] * Corresponding author. E-mail: jcharbel@gmail.com (C. Jacob Júnior).

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Evaluation of the effectiveness of platelet-rich plasma in the bone consolidation of patients submitted to lumbar arthrodesis☆ ☆ Study conducted at the Hospital Santa Casa de Misericórdia de Vitória, Grupo de Coluna Vertebral, Vitória, ES, Brazil.

ABSTRACT

OBJECTIVE:

METHOD:

RESULT:

CONCLUSION:

Evaluation of the effectiveness of platelet-rich plasma in the bone consolidation of patients submitted to lumbar arthrodesis^☆ ☆ Study conducted at the Hospital Santa Casa de Misericórdia de Vitória, Grupo de Coluna Vertebral, Vitória, ES, Brazil.