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Evaluation of autologous platelet concentrate for intertransverse process lumbar fusion.
Sethi, Paul M; Miranda, Jose J; Kadiyala, Sudha; Patel, Tushar Ch; Panjabi, Manohar; Troiano, Nancy; Friedlaender, Gary E.
Afiliação
  • Sethi PM; Orthopedic and Neurological Surgery Specialists, Greenwich, Connecticut, USA.
Am J Orthop (Belle Mead NJ) ; 37(4): E84-90, 2008 Apr.
Article em En | MEDLINE | ID: mdl-18535686
Data on the role of platelet concentrate (PC) in spinal fusion are limited. Using the New Zealand white rabbit model, we compared fusion rates at L5-L6 using 2 different volumes (1.5 cm(3), 3.0 cm(3)) of iliac crest autograft with and without PC (4 groups total, 10 animals in each). PC was collected from donor rabbits and adjusted to a concentration of 1 x 10(6) platelets/mL. Bone growth and fusion were evaluated using biomechanical, radiographic, and histologic testing. At 1.5 cm(3), autograft alone had a 29% fusion rate, compared with autograft plus PC, which had a 57% fusion rate (P = .06). At 3.0 cm(3), the fusion rate approached 90% in both groups. Radiologic fusion had a 70% correlation with biomechanical test results. Huo/Friedlaender scores were 4.3 (SD, 2.9) for 1.5-cm(3) autograft alone; 5.0 (SD, 3.5) for 1.5-cm(3) autograft plus PC; 4.7 (SD, 2.5) for 3.0-cm(3) autograft alone; and 7.7 (SD, 0.6) for 3.0-cm(3) autograft plus PC. For 1.5-cm(3) autograft, a trend toward improvement in biomechanically defined fusion was found when PC was added, which suggests that, when the amount of bone graft is limited, PC may function as a graft extender in posterolateral fusion. At higher volumes of bone graft, no appreciable difference was noted between groups. Although radiography revealed fusion masses, the technique was not useful in identifying pseudarthrosis. On histologic analysis, adding PC seemed to result in more mature bone at both volumes, with the most mature bone in the group with 3.0-cm(3) autograft plus PC.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fusão Vertebral / Transfusão de Plaquetas Tipo de estudo: Prognostic_studies Limite: Animals Idioma: En Revista: Am J Orthop (Belle Mead NJ) Assunto da revista: ORTOPEDIA Ano de publicação: 2008 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fusão Vertebral / Transfusão de Plaquetas Tipo de estudo: Prognostic_studies Limite: Animals Idioma: En Revista: Am J Orthop (Belle Mead NJ) Assunto da revista: ORTOPEDIA Ano de publicação: 2008 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos