The Effect of Amniotic Tissue on Spinal Interventions: A Systematic Review.

Autor:	Moore ML; Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona, USA., Deckey DG; Department of Orthopaedics, Mayo Clinic Arizona, Phoenix, Arizona, USA deckey.david@mayo.edu., Pollock JR; Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona, USA., Smith JH; Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota, USA., Tokish JM; Department of Orthopaedics, Mayo Clinic Arizona, Phoenix, Arizona, USA., Neal MT; Department of Neurosurgery, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Jazyk:	angličtina
Zdroj:	International journal of spine surgery [Int J Spine Surg] 2023 Feb; Vol. 17 (1), pp. 32-42. Date of Electronic Publication: 2022 Oct 17.
DOI:	10.14444/8380
Abstrakt:	Background: Amniotic membrane tissue has been thought to potentiate healing in many soft tissue conditions. Specifically, recent studies have shown its therapeutic potential for treatment in the setting of spinal pathologies. The purpose of this study is to thoroughly review the existing scientific literature and evidence concerning the clinical use of amniotic membrane-derived biologic agents on postoperative outcomes following spinal surgery. Methods: A systematic review was conducted following preferred reporting items for systematic reviews and meta-analyses guidelines using PubMed, Embase, and Cochrane databases up to December 2020 to identify animal and clinical studies examining the therapeutic potential for amniotic membrane tissue in the setting of spinal pathologies (including disc herniation, prevention of epidural fibrosis, and spinal fusion). Studies were broken down into 2 categories: experimental model type and the type of amnion product being analyzed. Results: A total of 12 studies (4 clinical studies and 8 studies utilizing animal models) met inclusion criteria. Additionally, the major types of amnion product were divided into cryopreserved/freeze-dried amniotic membrane, human amniotic fluid, human amniotic membrane, cross-linked amniotic membrane, and amnion-derived epithelial cells. While heterogeneity of study design precludes definitive specific results reporting, most studies showed positive benefits on healing/outcomes with amniotic augmentation. Specifically, amnion products have shown promising effects in reducing epidural adhesions and scar tissue after spine surgery, improving spinal fusion rate and postoperative pain scores, and promoting better functional outcomes after spine surgery. Conclusions: A review of the limited number of reported studies revealed a wide variety of amniotic membrane preparations, treatment regimens, and indications, which limit definitive conclusions. To date, while there is no definitive clinical proof that amniotic tissues enhance tissue repair or regeneration, the aggregate results demonstrate promising basic science and outcomes potential in spinal surgery. Further study is warranted to determine whether this application is appropriate in the clinical setting. Clinical Relevance: This systematic review provides a summary of the existing literature regarding the use of amniotic membrane preparations, treatment regimens, and indications within spinal surgery. With the growing popularity and utilization of biologic agents such as amniotic membrane-derived products in orthopedic and neurologic surgery, this systematic review gives physicians a concise summary on the outcomes and indications associated with amniotic membrane products. Competing Interests: Declaration of Conflicting Interests: John M. Tokish discloses that he has received consulting and/or speaking/teaching fees from Arthrex, Inc.; DePuy, A Johnson and Johnson Company; and Mitek. Dr Tokish has also received travel funds from Arthrex, Inc, DePuy Synthes, and Stryker Corporation. Dr Tokish is on the board of directors for JSES and Orthopedics Today and is on the scientific advisory board for the Arthroscopy Association of North America. Matthew T. Neal discloses that he has received consulting fees from Medtronic, Inc and travel funds from Globus Medical, Inc. The remaining authors have nothing to disclose. (This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2023 ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.)
Databáze:	MEDLINE
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