Liao Jen-Chung
Bone and Joint Research Center, Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chang Gung University, No. 5, Fu-Shin Street, Kweishian, Taoyuan, 333, Taiwan.
J Orthop Surg Res. 2019 Feb 6;14(1):39. doi: 10.1186/s13018-019-1076-2.
Platelet-rich plasma (PRP) is autologous in origin and contains a high concentration of platelets which is a source of various growth factors. Previous studies have suggested that PRP has a positive effect in accelerating fusion by an autologous bone graft in a lumbar fusion. The role of PRP on artificial bone grafts in spinal fusion remains controversial. In this study, positive effect on spinal fusion by PRP was hypothesized; in vitro and in vivo studies were designed to test this hypothesis.
PRP was produced from peripheral blood of Sprague-Dawley (SD) rats. A lumbar posterolateral arthrodesis model was used to test the efficacy of PRP on spinal fusion. Thirty SD rats were divided into three groups by different implants: the PRP group, PRP plus collagen-mineral carrier; the platelet-poor plasma (PPP) group, PPP plus collagen-mineral carrier; and the control group, collagen-mineral only. Spinal fusion was examined using plain radiographs, micro-computed tomography (micro-CT), manual palpation, and histological analysis. The fusion rate by micro-CT and that by manual palpation in groups were compared.
In the micro-CT results, 16 fused segments were observed in the PRP group (80%, 16/20), 2 in the PPP group (10%, 2/20), and 2 in the control group (10%, 2/20). The fusion rate, determined by manual palpation, was 60% (6/10) in the PRP group, 0% (0/10) in the PPP group, and 0% (0/10) in the control group. Histology showed that the PRP group had more new bone and matured marrow formation.
The results of this study demonstrated that PRP on an artificial bone carrier had positive effects on lumbar spinal fusion in rats. In the future, this composite could be potentially used as a bone graft in humans.
富血小板血浆（PRP）来源自体，含有高浓度血小板，而血小板是多种生长因子的来源。既往研究表明，PRP在腰椎融合术中对自体骨移植加速融合具有积极作用。PRP在脊柱融合术中对人工骨移植的作用仍存在争议。在本研究中，假设PRP对脊柱融合有积极作用；设计了体外和体内研究来验证这一假设。
从Sprague-Dawley（SD）大鼠外周血制备PRP。采用腰椎后外侧关节融合模型来测试PRP对脊柱融合的疗效。30只SD大鼠根据不同植入物分为三组：PRP组，PRP加胶原-矿物质载体；贫血小板血浆（PPP）组，PPP加胶原-矿物质载体；对照组，仅胶原-矿物质。使用X线平片、显微计算机断层扫描（micro-CT）、手动触诊和组织学分析来检查脊柱融合情况。比较各组通过micro-CT和手动触诊得到的融合率。
在micro-CT结果中，PRP组观察到16个融合节段（80%，16/20），PPP组2个（10%，2/20），对照组2个（10%，2/20）。通过手动触诊确定的融合率，PRP组为60%（6/10），PPP组为0%（0/10），对照组为0%（0/10）。组织学显示PRP组有更多新骨形成和成熟骨髓。
本研究结果表明，人工骨载体上的PRP对大鼠腰椎脊柱融合有积极作用。未来，这种复合材料有可能用作人类骨移植材料。
