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Scientific Articles   |    
The Effect of Platelet-Rich Plasma on Posterolateral Lumbar Fusion in a Rat Model
Hiroto Kamoda, MD, PhD1; Seiji Ohtori, MD, PhD1; Tetsuhiro Ishikawa, MD, PhD1; Masayuki Miyagi, MD, PhD1; Gen Arai, MD1; Miyako Suzuki, MD1; Yoshihiro Sakuma, MD1; Yasuhiro Oikawa, MD1; Go Kubota, MD1; Sumihisa Orita, MD, PhD1; Yawara Eguchi, MD, PhD1; Masaomi Yamashita, MD, PhD1; Kazuyo Yamauchi, MD, PhD1; Gen Inoue, MD, PhD1; Masahiko Hatano, MD, PhD1; Kazuhisa Takahashi, MD, PhD1
1 Department of Orthopedic Surgery, Graduate School of Medicine (H.K., S. Ohtori., T.I., M.M., G.A., M.S., Y.S., Y.O., G.K., S. Orita., Y.E., M.Y., K.Y., G.I., and K.T.), Biomedical Research Center (M.H.), Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan. E-mail address for H. Kamoda: kamodahiroto@gmail.com
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Investigation performed at Chiba University, Chiba, Japan



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2013 Jun 19;95(12):1109-1116. doi: 10.2106/JBJS.L.00320
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Abstract

Background: 

Our purpose was to examine platelet-rich plasma (PRP) for its effect on bone formation and to follow the immunohistochemical changes in calcitonin gene-related peptide (CGRP) in dorsal root ganglion neurons innervating the discs as a possible index of nociceptive nerve transmission in a rat model.

Methods: 

A total of seventy rats were used. Ten constituted a non-punctured disc sham group, while another ten rats constituted a group that underwent puncture of the L4-L5 discs. Forty rats were in experimental groups in which the L4-L5 discs were punctured; posterolateral lumbar arthrodesis was performed with PRP (the PRP group) or without the use of PRP (the normal arthrodesis group), with twenty rats in each group. The remaining ten rats were used as blood donors. Four and eight weeks after surgery, microcomputed tomography examinations were done to evaluate the amount of bone and the L4-L5 spines were harvested to evaluate bone union, followed by resection of dorsal root ganglion neurons. The percentages of Fluoro-Gold-labeled and CGRP-immunoreactive neurons were calculated.

Results: 

The platelet count and the concentration of growth factors in PRP were higher than those in blood (p < 0.05). The bone volumes observed in the PRP group were significantly greater than those of the normal arthrodesis group at four and eight weeks (p < 0.05). Three (30%; 95% confidence interval [CI], 6% to 65%) of ten rats in the normal arthrodesis group and eight (80%; 95% CI, 44% to 98%) of ten rats in the PRP group were considered to have bone fusion four weeks after surgery (p < 0.05). At eight weeks, seven (70%; 95% CI, 34% to 94%) of ten rats in the normal arthrodesis group and nine (90%; 95% CI, 55% to 99%) of ten rats in the PRP group were considered to have bone fusion (p = 0.27). The proportion of CGRP-immunoreactive neurons was significantly greater in the punctured group than in the other groups. There were no significant differences between the normal arthrodesis group and the PRP group.

Conclusions: 

PRP appears to promote bone formation in rats and has a tendency to shorten the period of bone union in this rat model of posterolateral lumbar arthrodesis, but it did not influence the proportion of CGRP-immunoreactive neurons, a likely indicator of inflammatory pain originating from the degenerative intervertebral disc.

Clinical Relevance: 

The ability of PRP in this model suggests that it may be able to shorten the period of union and lead to an early return to social activities after treatment.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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