THE RESULTS OF AUTOTRANSFUSION WITH PLATELET RICH PLASMA IN SPINAL NEUROSURGERY

  • E. G. Pedachenko SI "Romodanov Institute of Neurosurgery of National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • M. V. Khyzhnyak SI "Romodanov Institute of Neurosurgery of National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • O. O. Potapov Medical Institute of Sumy State University, Sumy, Ukraine
  • Yu. E. Pedachenko SI "Romodanov Institute of Neurosurgery of National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • O. F. Tanasiichuk SI "Romodanov Institute of Neurosurgery of National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • O. P. Krasylenko SI "Romodanov Institute of Neurosurgery of National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • A. M. Furman SI "Romodanov Institute of Neurosurgery of National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • I. G. Vasylieva SI "Romodanov Institute of Neurosurgery of National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • N. G. Chopyk SI "Romodanov Institute of Neurosurgery of National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • N. P. Oleksenko SI "Romodanov Institute of Neurosurgery of National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
Keywords: lumbar spine; transpedicular interbody fusion; platelet-rich plasma

Abstract

Introduction. Рlatelet-rich plasma (PRP), a blood plasma separated by centrifugation with highly abundant platelets, has multiple applications in many healthcare fields for the improvement of soft and bone tissues regeneration. The studies of PRP implementation results in spine neurosurgery are of high demand in case of pathologies related to the degeneration or injury of living bone and cartilaginous elements of vertebral column, which require the installation of vertebral interbody fusion system.

Purpose. Improvement of surgical treatment outcomes by means of improving postoperative wound healing and reducing pain severity after the installation of transpedicular fixation systems in the lumbar spine using a biotechnological method which has a multimodal effect on regeneration processes and is simple and cost-effective

Materials and Methods. The results of transpedicular stabilization in lumbar spine vertebral column were assessed within the early post-operational period in two groups of patients comparable in age and health status with spondylolisthesis and spinal motion segment instability. Patients from the main group (n = 20, average age 47.8 ± 6.6 years) received PRP during the operation as compared to the control one (n = 30, average age 46.9 ± 5.6 years) without PRP injections.

Results. It was found that during the first day post-operation the pain severity in the main group was significantly reduced (1.6 ± 0.7 points according to the visual analogous scale) as compared to the control (3.8 ± 0.9 points). Moreover, these characteristics before the discharge of the patients were 0.3 ± 0.3 and 2.0 ± 0.4 points respectively. It is noteworthy that the swelling and wound edges hyperemia were remarkably reduced after the PRP use. Finally, no complications, side-effect or systemic consequences of PRP were observed.

Conclusions. Therefore, the local injections of PRP during the installment of transpedicular stabilization system in lumbar spine is easy-to-handle and safe approach favoring the quick recovery in early post-operational period.

References

1. Marx RE. [Platelet- Rich Plasma (PRP): what is PRP and what is not PRP]. Implant Dent. 2001; 10: 255-258.
2. Piccin A, Di Pierro AM, Canzian L, [et al.]. [ Platelet gel: a new therapeutic tool with great potential]. Blood Transfus. 2017;15(4):333-340.
3. Middleton KK, Barro V, Muller B, [et al.]. [Evaluation of the effects of patelet-rich plasma (PRP) therapy involved in the healing of sports-related soft tissue injuries]. Iowa Orthop J. 2012; 32:150-163.
4. Eppley BL, Pietrzak WS, Blanton M. [Platelet-rich plasma: a review of biology and applications in plastic surgery]. Plast Reconstr Surg. 2006; 118(6):147e–159e.
5. Akeda K, An HS, Pichika R, [et al.]. [Platelet-rich plasma (PRP) stimulates the extracellular matrix metabolism of porcine nucleus pulposus and anulus fibrosus cells cultured in alginate beads]. Spine (Phila Pa 1976). 2006; 31(9):959-966.
6. Kim E. S., Kim J. J., Park E. J. [Angiogenic factor-enriched platelet-rich plasma enhances in vivo bone formation around alloplastic graft material]. J Adv Prosthodont. 2010; 2(1):7-13.
7. Gaissmaier C, Koh JL, Weise K. [Growth and differentiation factors for cartilage healing and repair]. Injury. 2008; 39(1):S88-96.
8. Dolder J, Mooren R, Vloon A, [et al.]. [Platelet-rich plasma: quantification of growth factor levels and the effect on growth and differentiation of rat bone marrow cells]. Tissue Engineering. 2006; 12(11):3067–3073.
9. Brandl A, Angele P, Roll C, [et al.]. [Influence of the growth factors PDGF-BB, TGF-β1 and bFGF on the replicative aging of human articular chondrocytes during in vitro expansion]. Journal of Orthopaedic Research. 2010; 28(3):354–360.
10. Fortier L, Mohammed H, Lust G, Nixo A. [Insulin-like growth factor-I enhances cell-based repair of articular cartilage]. The Journal of Bone and Joint Surgery. 2002; 84(2):276–288.
11. Elder BD, Holmes C, Goodwin CR, [et al.]. [A systematic assessment of the use of platelet-rich plasma in spinal fusion]. Ann Biomed Eng. 2015; 43(5):1057-1070.
12. Louis M, Magalon J, Jouve E, [et al.]. [Growth factors levels determine efficacy of platelets rich plasma injection in knee osteoarthritis: a randomized double blind noninferiority trial compared with viscosupplementation]. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2018; 34(5):1530–1540.
13. Macaulay I. [Platelet genomics and proteomics in human health and disease]. Journal of Clinical Investigation. 2005; 115(12):3370–3377.
14. McRedmond J, Park S, Reilly D, [et al.]. [Integration of proteomics and genomics in platelets]. Molecular & Cellular Proteomics. 2003; 3(2):133–144.
15. Watson S, Bahou W, Fitzerald D, [et al.]. [Mapping the platelet proteome: a report of the ISTH Platelet Physiology Subcommittee]. Journal of Thrombosis and Haemostasis. 2005; 3(9):2098–2101.
16. Akeda K, An H, Okuma M, [et al.]. [Platelet-rich plasma stimulates porcine articular chondrocyte proliferation and matrix biosynthesis]. Osteoarthr Cartil. 2006; 14(12):1272–1280.
17. Spreafico A, Chellini F, Frediani B, [et al.]. [Biochemical investigation of the effects of human platelet releasates on human articular chondrocytes]. J Cell Biochem. 2009; 108(5):1153–1165.
18. Kaps C, Loch A, Haisch A, [et al.]. [Human platelet supernatant promotes proliferation but not differentiation of articular chondrocytes]. Med Biol Eng Comput. 2002; 40(4):485–490.
19. Gaissmaier C, Fritz J, Krackhardt T, [et al.]. [Effect of human platelet supernatant on proliferation and matrix synthesis of human articular chondrocytes in monolayer and three-dimensional alginate cultures]. Biomaterials. 2005; 26(14):1953–1960.
20. Drengk A, Zapf A, Sturmer EK, [et al.]. [Influence of platelet-rich plasma on chondrogenic differentiation and proliferation of chondrocytes and mesenchymal stem cells]. Cells Tissues Organs. 2009; 189(5):317–326.
21. Kazemi D, Fakhrjou A. [Leukocyte and platelet rich plasma (L-PRP) versus leukocyte and platelet rich fibrin (L-PRF) for articular cartilage repair of the knee: a comparative evaluation in an animal model]. Iran Red Crescent Med J. 2015; 17(10):e19594.
22. Zhu Y, Yuan M, Meng HY, [et al.]. [Basic science and clinical application of platelet-rich plasma for cartilage defects and osteoarthritis: a review]. Osteoarthritis Cartilage. 2013; 21(11):1627–1637.
23. Slater M, Patava J, Kingham K, Mason RS. [Involvement of platelets in stimulating osteogenic activity]. J. Orthop. Res. 1995; 13:655–663.
24. Saltzman BM, Jain A, Campbell KA, [et al.]. [Does the use of platelet-rich plasma at the time of surgery improve clinical outcomes in arthroscopic rotator cuff repair when compared with control cohorts? A systematic review of meta-analyses]. Arthroscopy. 2016; 32(5):906–918.
25. Gaissmaier C, Fritz J, Krackhardt T, [et al.]. [Effect of human platelet supernatant on proliferation and matrix synthesis of human articular chondrocytes in monolayer and three-dimensional alginate cultures]. Biomaterials. 2005; 26(14):1953–1960.
26. Pedachenko EG, Vasylieva IG, Khyzhnyak MV, [et al.]. [The concentration-dependent impact of platelet-rich plasma on chondrogenic markers gene expression in cells of nucleus pulposus at in vitro injury modelling]. Vpliv zbagachenoyi trombotsitami plazmi riznoyi kontsentratsiyi na ekspresiyu geniv hondrogennih markeriv v klitinah pulpoznogo yadra v umovah modelyuvannya travmi in vitro. [Materials of scientific and practical conference with international participation “Innovative trends in genetics and regenerative medicine”]. Kyiv, 2017. [In Ukrainian]
27. Bendinelli P, Matteucci E, Dogliotti G, [et al.]. [Molecular basis of anti-inflammatory action of platelet-rich plasma on human chondrocytes: mechanisms of NF-κB inhibition via HGF]. J Cell Physiol. 2010; 225:757-766.
28. Mazzocca AD, McCarthy MB, Intravia J, [et al.]. [An in vitro evaluation of the anti-inflammatory effects of platelet-rich plasma, ketorolac, and methylprednisolone]. Arthroscopy 2013; 29:675-683.
29. van Buul GM, Koevoet WL, Kops N, [et al.]. [Platelet-rich plasma releasate inhibits inflammatory processes in osteoarthritic chondrocytes]. Am J Sports Med. 2011; 39:2362-2370.
30. Drago L, Bortolin M, Vassena C, [et al.]. [Antimicrobial activity of pure platelet-rich plasma against microorganisms isolated from oral cavity]. BMC Microbiol 2013; 13:47.
31. Khimion LV, Smolina LO. NovitnI metodi likuvannya osteoartrozu kolinnih suglobiv [Novel methods of knee joints osteoarthrosis treatment]. Rational pharmacotherapy. 2016; 4(41):5-10.
32. Marx RE, Carlson ER, Eichstaedt RM, [et al.]. [Platelet-rich plasma: growth factor enhancement for bone grafts]. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 1998; 85:638-646.
33. Korytkin AA, Zykin AA, Zakharova DV, Novikova Ya S. Primenenie obogaschennoy trombotsitami plazmyi pri zameschenii ochaga avaskulyarnogo nekroza golovki bedrennoy kosti allotransplantatami [A use of platelet-rich plasma in the replacement of the focal point of femoral head avascular necrosis by allotransplantants]. Traumatology and Orthopedics. 2018; 24(1):115-122.
34. Andia I, Sánchez M, Maffulli N. [Joint pathology and platelet-rich plasma therapies]. Expert Opin Biol Ther. 2012; 12(1):7–22.
35. Hussain N, Johal H, Bhandari M. [An evidence-based evaluation on the use of platelet rich plasma in orthopedics – a review of the literature]. SICOT J. 2017; 3(57):1-7.
36. Mishra A, Harmon K, Woodall J, Vieira A. [Sports medicine applications of platelet rich plasma]. Curr Pharm Biotechnol. 2012; 13(7):1185–1195.
37. Smyth NA, Murawski CD, Fortier LA, [et al.]. [Platelet-rich plasma in the pathologic processes of cartilage: review of basic science evidence]. Arthroscopy. 2013; 29(8):1399-1409.
38. Mlynarek RA, Kuhn AW, Bedi A. [Platelet-rich plasma (PRP) in orthopedic sports medicine]. Am J Orthop (Belle Mead NJ). 2016; 45(5):290-326.
39. Dai WL, Zhou AG, Zhang H, Zhang J. [Efficacy of platelet-rich plasma in the treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials]. Arthroscopy. 2017; 33(3):659-670.
40. Everhart JS, Cole D, Sojka JH, [et al.]. [Treatment options for patellar tendinopathy: a systematic review]. Arthroscopy. 2017; 33:861-872.
41. Di Matteo B, Filardo G, Kon E, Marcacci M. [Platelet-rich plasma: evidence for the treatment of patellar and аchilles tendinopathy – a systematic review]. Musculoskelet Surg. 2015; 99(1):1-9.
42. Smith RG, Gassmann CJ, Campbell MS. [Platelet-rich plasma: properties and clinical applications]. The Journal of Lancaster General Hospital. 2007; 2(2):73-78.
43. Feiz-Erfan I, Harrigan M, Sonntag VK, Harrington TR. [Effect of autologous platelet gel on early and late graft fusion in anterior cervical spine surgery]. J. Neurosurg. Spine. 2007; 7:496-502.
44. Hartmann EK, Heintel T, Morrison RH, Weckbach A. [Influence of platelet-rich plasma on the anterior fusion in spinal injuries: a qualitative and quantitative analysis using computer tomography]. Arch. Orthop. Trauma Surg. 2010; 130:909-914.
45. Landi A, Tarantino R, Marotta N, [et al.]. [The use of platelet gel in postero-lateral fusion: preliminary results in a series of 14 cases]. Eur. Spine J. 2011; 20(1):S61-S67.
46. Hee HT, Majd ME, Holt RT, Myers L. [Do autologous growth factors enhance transforaminal lumbar interbody fusion?]. Eur. Spine J. 2003; 12:400-407.
47. Lind M. [Growth factor stimulation of bone healing. Effects on osteoblasts, osteomies, and implants fixation]. ACTA Orthop Scand 1998; 283:2-37.
48. Kamoda H, Ohtori S, Ishikawa T, [et al.]. [The effect of platelet-rich plasma on posterolateral lumbar fusion in a rat model]. J. Bone Joint Surg. Am. 2013; 95:1109-1116.
49. Okamoto S, Ikeda T, Sawamura K, [et al.]. [Positive effect on bone fusion by the combination of platelet-rich plasma and a gelatin beta-tricalcium phosphate sponge: a study using a posterolateral fusion model of lumbar vertebrae in rats]. Tissue Eng. 2012; Part A 18:157–166.
50. Rao RD, Gourab DK, Bagaria VB, [et al.]. [The effect of platelet-rich plasma and bone marrow on murine posterolateral lumbar spine arthrodesis with bone morphogenetic protein]. J. Bone Joint Surg. Am. 2009; 91:1199-1206.
51. Sethi PM. Miranda JJ, Kadiyala S, [et al.]. [Evaluation of autologous platelet concentrate for intertransverse process lumbar fusion]. Am. J. Orthop. (Belle Mead NJ). 2008; 37:E84-E90.
52. Walsh WR, Loefler A, Nicklin S, [et al.]. [Spinal fusion using an autologous growth factor gel and a porous resorbable ceramic]. Eur. Spine J. 2004; 13:359-366.
53. Acebal-Cortina G, Suarez-Suarez MA, Garcia-Menendez C, [et al.]. [Evaluation of autologous platelet concentrate for intertransverse lumbar fusion]. Eur. Spine J. 2011; 20(3):361-366.
54. Castro FP. [Role of activated growth factors in lumbar spinal fusions]. J. Spinal Disord. Tech. 2004; 17:380–384.
Published
2020-10-04
How to Cite
E. G. Pedachenko, M. V. Khyzhnyak, O. O. Potapov, Yu. E. Pedachenko, O. F. Tanasiichuk, O. P. Krasylenko, A. M. Furman, I. G. Vasylieva, N. G. Chopyk, & N. P. Oleksenko. (2020). THE RESULTS OF AUTOTRANSFUSION WITH PLATELET RICH PLASMA IN SPINAL NEUROSURGERY. Eastern Ukrainian Medical Journal, 6(4), 424–431. Retrieved from https://eumj.med.sumdu.edu.ua/index.php/journal/article/view/110