Use of Autologous Growth Factors in Lumbar Spinal Fusion

Introduction:

Autologous growth factor concentrate (AGF) prepared by ultraconcentration of platelets, contains multiple growth–factors having a chemotactic and mitogenic effect on mesenchymal cells and osteoblasts. This retrospective study reviews our results with use of AGF in lumbar spinal fusions.

Methods:

AGF has been used in 44 patients having lumbar spinal fusion between Aug–97 and Mar–99. 22 patients have more than 6 months follow–up. Average follow–up was 7 months (range: 5–21 months). Follow–up compliance was 93%. There were 19 males and 25 females. Average age was 53 years (range: 30–77 years). 26 patients had prior back surgery. There were 17 smokers. AGF were used in posterolateral (n=4O) or anterior intradiscal (N=4) fusions. Concomitant intradiscal fusion was performed in 63% of the posterolateral fusion cases. Autologous bone graft, coralline and AGF were used for all posterior fusions. Carbon fiber or titanium cages with coral, autograft and AGF were used for intradiscal fusions. Posterior stabilization was used in all cases. Most patients had 1–level (14) or 2–level (17) fusions.

Results:

No impending pseudoarthroses were noted on plain radiographs at six months in 22 patients. Solid fusion was confirmed in 3 patients during routine hardware removal, and in 2 patients during adjacent level surgery. One posterior wound infection was managed without sequelae.

Conclusions:

When used as an adjunct to autograft, AGF offers theoretical advantages that need further controlled study. Coralline hydroxyapatite used as a bone graft extender may obviate the need for secondary site graft harvesting.