Effect of Platelet-Rich-Plasma in Spine Fusion

NCT ID: NCT03779945

Last Updated: 2018-12-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-12-20

Study Completion Date

2020-01-20

Brief Summary

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The objective of this study is to evaluate the fusion rate after the use of platelet rich plasma with autolgus bone graft and comparing it with bone graft alone

Detailed Description

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The study will be submitted for approval by the Ethics Committee of Faculty of Medicine, Assiut University, and written informed consent will be obtained from all patients prior to enrollment. The study population will be selected from patients attending the Department of Orthopedics and Trauma surgery, Assiut University hospitals.

A total of 104 patients treated with single level degenerative or lytic lumbar Spondylolisthesis indicated for PLF will be included ,patients will be classified into 2 groups Group A:Of 52 patients PLF + autologus bone graft+ PRP Group B: Of 52 patients treated with PLF + autologus bone graft only without adding PRP

Methods of evaluation

* History taking.
* Full clinical and neurological examination
* Radiological evaluation by x-ray (antero posterior, lateral, and, CT scans provide excellent views of bony detail) and MRI if needed Method of randomization By shuffling cards method the candidate patient will choose one card from104 cards 52 of them containing fusion with PRP and the other 52 contaning Fusion without PRP

Platelet-rich plasma (PRP is obtained using a two-stage centrifugation process:

Whole blood sample will be drawn from the participant and be collected in a sterile tube containing anticoagulant (sodium citrate 3.8% or Ethylenediaminetetra acetic acid). The tube will be centrifuged at 160xg relative centrifugal force (about 1000 round per minute) for 10 min in a centrifugal apparatus. The first spin will separate platelet poor plasma at the top from red blood cells at the bottom and platelet rich plasma above (mixed with the white blood cells in the buffy coat). The Platelet poor plasma, Platelet rich plasma and a few red blood cells will be aspirated into a new tube, mixed and in the second spin, the tube will be centrifuged at 400xg relative centrifugal form (about 1500 round per minute) for another 10 minutes. The upper section will consist of Platelet poor plasma and the Platelet rich plasma will be collected at the bottom of the tube in the form of pellet. Then, Platelet poor plasma and Platelet rich plasma will be aspirated and mixed (discarding the upper portion). Prior to treatment calcium chloride 3% will be added to activate platelets specimen

Conditions

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Platelet-Rich Plasma

Keywords

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PRP

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

single center, prospective randomized comparative trial
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
the person performing the statistical analysis shall be masked

Study Groups

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posteriolateral lumbar fusion +bone graft+ PRP

the addition of autologous platelet rich plasma to the bone graft

Group Type ACTIVE_COMPARATOR

autologous platelet rich plasma

Intervention Type BIOLOGICAL

adding autologous platelet rich plasma to the bone graft harvested from the patient

posteriolateral lumbar fusion+bone graft only

posteriolateral lumbar fusion with adding autologus bone graft alone posteriolateral lumbar fusion only

Group Type ACTIVE_COMPARATOR

posteriolateral lumbar fusion only

Intervention Type PROCEDURE

performing posteriolateral lumbar fusion without using platelet rich plasma

Interventions

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autologous platelet rich plasma

adding autologous platelet rich plasma to the bone graft harvested from the patient

Intervention Type BIOLOGICAL

posteriolateral lumbar fusion only

performing posteriolateral lumbar fusion without using platelet rich plasma

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

degenerative or lytic Spondylolisthesis.

Degenerative disc disease requiring posterior lumbar fusion not responding to medical treatment for 1 year.

Age between 20 \& 75 years.

Single level fusion

Exclusion Criteria

Multiple levels patient Traumatic Spondylolisthesis Previous lumbar spine surgery. Other lumbar spine pathology severe osteoporosis Patients younger than 20 years old. Patients older than 75 years old. Immunocompromised patients (eg. Chronic renal failure)
Minimum Eligible Age

20 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Micheal Bassem Elia

orthopedics resident

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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El Moataz A Zohny El Sabrout, professor

Role: STUDY_CHAIR

Assiut University

Essam M Abdelmoneim Elmorshedy, Lecturer

Role: PRINCIPAL_INVESTIGATOR

Assiut University

. Belal O Mohamed Elnady, Lecturer

Role: PRINCIPAL_INVESTIGATOR

Assiut University

Central Contacts

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Micheal B Elia, doctor

Role: CONTACT

Phone: 01282682989

Email: [email protected]

References

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Kubota G, Kamoda H, Orita S, Yamauchi K, Sakuma Y, Oikawa Y, Inage K, Sainoh T, Sato J, Ito M, Yamashita M, Nakamura J, Suzuki T, Takahashi K, Ohtori S. Platelet-rich plasma enhances bone union in posterolateral lumbar fusion: A prospective randomized controlled trial. Spine J. 2019 Feb;19(2):e34-e40. doi: 10.1016/j.spinee.2017.07.167. Epub 2017 Jul 20.

Reference Type BACKGROUND
PMID: 28735763 (View on PubMed)

Shiga Y, Orita S, Kubota G, Kamoda H, Yamashita M, Matsuura Y, Yamauchi K, Eguchi Y, Suzuki M, Inage K, Sainoh T, Sato J, Fujimoto K, Abe K, Kanamoto H, Inoue M, Kinoshita H, Aoki Y, Toyone T, Furuya T, Koda M, Takahashi K, Ohtori S. Freeze-Dried Platelet-Rich Plasma Accelerates Bone Union with Adequate Rigidity in Posterolateral Lumbar Fusion Surgery Model in Rats. Sci Rep. 2016 Nov 11;6:36715. doi: 10.1038/srep36715.

Reference Type BACKGROUND
PMID: 27833116 (View on PubMed)

Imagama S, Ando K, Kobayashi K, Ishikawa Y, Nakamura H, Hida T, Ito K, Tsushima M, Matsumoto A, Morozumi M, Tanaka S, Machino M, Ota K, Nakashima H, Takamatsu J, Matsushita T, Nishida Y, Ishiguro N, Matsuyama Y. Efficacy of Early Fusion With Local Bone Graft and Platelet-Rich Plasma in Lumbar Spinal Fusion Surgery Followed Over 10 Years. Global Spine J. 2017 Dec;7(8):749-755. doi: 10.1177/2192568217696690. Epub 2017 Apr 11.

Reference Type BACKGROUND
PMID: 29238638 (View on PubMed)

Tarantino R, Donnarumma P, Mancarella C, Rullo M, Ferrazza G, Barrella G, Martini S, Delfini R. Posterolateral arthrodesis in lumbar spine surgery using autologous platelet-rich plasma and cancellous bone substitute: an osteoinductive and osteoconductive effect. Global Spine J. 2014 Aug;4(3):137-42. doi: 10.1055/s-0034-1376157. Epub 2014 May 3.

Reference Type BACKGROUND
PMID: 25083353 (View on PubMed)

Other Identifiers

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PRP in lumbar fusion

Identifier Type: -

Identifier Source: org_study_id