Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
J Bone Joint Surg Am. 2013 Jun 19;95(12):1109-16. doi: 10.2106/JBJS.L.00320.
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.
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.
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.
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.
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.
我们的目的是研究富血小板血浆（PRP）对骨形成的影响，并研究降钙素基因相关肽（CGRP）在支配椎间盘的背根神经节神经元中的免疫组织化学变化，作为一种可能的伤害性神经传递的指标在大鼠模型中。
共使用 70 只大鼠。10 只构成未穿刺椎间盘假手术组，另 10 只构成 L4-L5 椎间盘穿刺组。40 只大鼠为实验组，其中 L4-L5 椎间盘穿刺，后路腰椎融合术（PRP 组）或不使用 PRP（正常融合术组），每组 20 只。其余 10 只大鼠用作供者。术后 4 周和 8 周时，行微计算机断层扫描检查评估骨量，采集 L4-L5 脊柱评估骨融合，然后切除背根神经节神经元。计算氟金标记和 CGRP 免疫反应性神经元的百分比。
PRP 中的血小板计数和生长因子浓度均高于血液（p < 0.05）。PRP 组在术后 4 周和 8 周时观察到的骨体积明显大于正常融合术组（p < 0.05）。在正常融合术组中，有 3 只（30%；95%置信区间[CI]，6%至 65%）和 8 只（80%；95%CI，44%至 98%）的大鼠被认为在术后 4 周时具有骨融合（p < 0.05）。在 8 周时，正常融合术组中 7 只（70%；95%CI，34%至 94%）和 PRP 组中 9 只（90%；95%CI，55%至 99%）的大鼠被认为具有骨融合（p = 0.27）。与其他组相比，穿刺组 CGRP 免疫反应性神经元的比例明显更高。正常融合术组和 PRP 组之间无显著性差异。
PRP 似乎能促进大鼠骨形成，并在这种后路腰椎融合术大鼠模型中缩短骨融合时间，但对降钙素基因相关肽免疫反应性神经元的比例没有影响，这可能是来源于退行性椎间盘的炎症性疼痛的一个指标。
该模型中 PRP 的能力表明，它可能能够缩短融合时间，并在治疗后导致早期恢复社会活动。
