Posterolateral arthrodesis in lumbar spine surgery using autologous platelet-rich plasma and cancellous bone substitute: an osteoinductive and osteoconductive effect

Roberto Tarantino, Pasquale Donnarumma, Cristina Mancarella, Marika Rullo, Giancarlo Ferrazza, Gianna Barrella, Sergio Martini, Roberto Delfini, Roberto Tarantino, Pasquale Donnarumma, Cristina Mancarella, Marika Rullo, Giancarlo Ferrazza, Gianna Barrella, Sergio Martini, Roberto Delfini

Abstract

Study Design Prospective cohort study. Objectives To analyze the effectiveness and practicality of using cancellous bone substitute with platelet-rich plasma (PRP) in posterolateral arthrodesis. Methods Twenty consecutive patients underwent posterolateral arthrodesis with implantation of cancellous bone substitute soaked with PRP obtained directly in the operating theater on the right hemifield and cancellous bone substitute soaked with saline solution on the right. Results Computed tomography scans at 6 and 12 months after surgery were performed in all patients. Bone density was investigated by comparative analysis of region of interest. The data were analyzed with repeated-measures variance analyses with value of density after 6 months and value of density after 12 months, using age, levels of arthrodesis, and platelet count as covariates. The data demonstrated increased bone density using PRP and heterologous cancellous block resulting in an enhanced fusion rate during the first 6 months after surgery. Conclusions PRP used with cancellous bone substitute increases the rate of fusion and bone density joining osteoinductive and osteoconductive effect.

Keywords: PRP; bone substitute; cancellous bone; posterolateral arthrodesis.

Conflict of interest statement

Disclosures None

Figures

Fig. 1
Fig. 1
(A) Centrifuge placed in the operating room. (B) After centrifugation, red blood cells trapped below the filter of gel content at the base of the tube. The upper portion is divided in the platelet-rich plasma and in the upper buffy-coat; (C) bone block; (D) intraoperative picture.
Fig. 2
Fig. 2
Region of interest (ROI) analysis on computed tomography scan 6 months after surgery.
Fig. 3
Fig. 3
Coronal computed tomography scan 6 months after surgery.
Fig. 4
Fig. 4
Bone density between the left and the right hemifields at 6 and 12 months.

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