Platelet-Rich Plasma Combined With Hydroxyapatite for Lumbar Interbody Fusion Promoted Bone Formation and Decreased an Inflammatory Pain Neuropeptide in Rats

Autor: Hiroto Kamoda, Miyako Suzuki, Gen Inoue, Tomoyuki Ozawa, Yoshihiro Sakuma, Yawara Eguchi, Sumihisa Orita, Masaomi Yamashita, Tetsuhiro Ishikawa, Tomoaki Toyone, Gen Arai, Yuichi Wada, Yasuhiro Oikawa, Kazuhisa Takahashi, Masayuki Miyagi, Seiji Ohtori
Rok vydání: 2012
Předmět:
Zdroj: Spine. 37:1727-1733
ISSN: 0362-2436
DOI: 10.1097/brs.0b013e31825567b7
Popis: Study design A prospective interventional trial, using a rat model of lumbar interbody fusion. Objective To examine the potential efficacy of platelet-rich plasma (PRP) for lumbar interbody fusion, using hydroxyapatite (HA). Summary of background data PRP is an autologous product containing a high concentration of platelets in a small volume of plasma and has osteoinductive effects. HA has osteoconductive ability and has been used in combination with autogenous bone for spine fusion. However, reports using PRP with HA for spine fusion are very few. The purpose of this study was to examine the efficacy of PRP with HA for spinal interbody fusion and at the same time to estimate the change in immunoreactivity of the inflammatory neuropeptide, calcitonin gene-related peptide (CGRP), in dorsal root ganglion (DRG) neurons innervating spinal discs. Methods A total of 35 Sprague-Dawley rats were used in this study. Twenty-one rats were used for conducting interbody fusion experiments, 7 rats were used as immunostaining controls, and 7 other rats were used as blood donors for making PRP. L5-L6 interbody fusion was performed on 21 rats using HA + PRP (n = 7), HA + platelet-poor plasma (n = 7), or HA + saline (n = 7). Simultaneously, Fluoro-Gold neurotracer was applied to the intervertebral space to detect DRG neurons innervating the discs. L5-L6 lumbar radiographs were obtained and lumbar DRGs were immunostained for CGRP. The rate of bone union and the change in CGRP immunoreactive DRG neurons innervating the discs were evaluated and compared among groups. Results All L5-L6 lumbar discs were fused in the PRP + HA group (fused 7/total 7), whereas only 1 case was fused in the platelet-poor plasma group (1 of 7) and no cases in the HA-only group (0 of 7), which was a significant difference. Upon immunohistochemical analysis, CGRP-positive neurons innervated L5-L6 intervertebral discs in nonunion cases, and these were significantly increased compared with those in union cases. Conclusion Our study suggests that using PRP with HA was beneficial for spine fusion. This combination may promote bone union and also decrease inflammatory neuropeptide in sensory neurons innervating the discs.
Databáze: OpenAIRE