The use of platelet-rich fibrin in lumbar interbody fusion in lytic spondylolisthesis

Abstract

Study Design: This was a retrospective observational study. Aim: The aim of this study was to evaluate the effectiveness of applying the platelet-rich fibrin (PRF) with bone graft in accelerating the rate of lumbar interbody fusion. Settings and Design: This was a retrospective study measuring the outcome of posterior lumbar interbody fusion (PLIF) combined with PRF versus PLIF alone in the management of lytic spondylolisthesis. Subjects and Methods: Forty patients were treated with instrumented PLIF for low-grade lytic spondylolisthesis and divided into two equal groups: one with addition of PRF to the bone graft and the other without. The minimum follow-up was 2 years. Clinical outcome was measured by the Oswestry Disability Index (ODI) and Visual Analogue Pain Scale (VAS) at 3, 6, and 12 months postoperatively. Radiological outcome was measured by standing X-ray at 3, 6, 12, and 24 months and computed tomography at 6 and 12 months postoperatively. Results: ODI for the PRF group improved by 60% and 79% at 6 and 12 months, respectively, whereas for the non-PRF group, it improved by 55% and 70%. Radiological outcome showed fusion in 15 of 20 cases in the PRF group (75%) by the 6th month and in 19 of 20 cases (95%) by 1 year and 100% at 2 years. In the control group, fusion was present in 12 of 20 cases (60%) by the 6th month and in 13 of 20 cases in the PRF group (65%) by 1 year and 90% at 2 years (P < 0.05). Conclusions: These preliminary results show that PRF accelerates the rate of fusion in low-grade lytic spondylolisthesis in short-term follow-up.

Keywords

• autologous growth factors
• lumbar interbody fusion
• lytic spondylolisthesis
• platelet-rich fibrin