Role of Platelet-Rich Plasma in Spinal Fusion Surgery: SystematicReview and Meta-Analysis

Platelet-rich plasma (PRP) has been used very successfully in enhancing bone fusion in animal experiments. Also, theefficaciousness of PRP in other specialties of medicine such as dentistry, dermatology ophthalmology, and sports medicine is welldocumented. But the use of PRP to augment bone fusion after spinal surgery in humans is still controversial. We conducted ameta-analysis to determine the role of PRP in enhancing spinal fusion by fastening the rate of new bone formation and decreasingpain after spinal surgery in humans.Methods. We searched PubMed, EMBASE, and the Cochrane Library studies that comparedPRP versus control in enhancing spinal fusion after deformity correction.Results. Five retrospective studies with 253 participantsand nine prospective cohort studies with 460 participants were identified. ,e bone fusion rate was excellent for studies that used ahigh platelet concentration in PRP relative to control (odds ratio (OR)�4.35, 95% confidence interval (CI) (2.13, 8.83), andP<0.05) while bone fusion was poor to studies that used a low concentrate of platelet in PRP relative to control. ,e rate of newbone formation was high in the PRP group compared to the control group with the mean difference in Hounsfield unit (HU)144.91 (95% CI (80.63, 209.18),P<0.05). Time to bone fusion was short in the PRP group during the first six months of surgeryrelative to the control group with a mean difference of−2.03 (95% CI (−2.35,−1.7);P<0.05). No difference was found in painreduction by visual analog score (VAS) between the PRP group and control.Conclusion. PRP facilitates new bone formation andbone fusion with a minimum concentration of the growth factor 5 times that of the peripheral blood. PRP stimulatory effects arenot continuous and are very effective within six months of implantation.