title: Platelet concentrates in spine fusion: meta-analysis of union rates and complications in controlled trials.
abstract: Platelet concentrates in spine fusion gained increasing popularity among spine surgeons. They avoid morbidity of bone harvest and promise good union rates without additional device-related adverse events. Therefore, they seem to be a safe and effective alternative to common bone substitutes. This meta-analysis assesses the available evidence for union rate and overall complications with the use of platelet concentrates in spine fusion.
  
  
  
  We conducted an online search for relevant controlled trials and extracted data on union rates, complications, and revision rates. These data were synthesized in a meta-analysis using fixed-effects odds ratios (OR). To assess covariates, meta-regression was performed as well.
  
  
  
  Our search produced 166 results, ten of which were eligible for inclusion. These studies report on a total of 763 patients (328 experimental, 435 controls) with a mean age of 50.3 ± 7.5 years. Mean follow-up was 1.9 ± 0.0.4 years. With the use of platelet concentrates, union rate decreased significantly, OR 0.53 (95 % CI 0.35-0.79, p = 0.002), compared with the control group. There was no statistically significant difference in complication rates OR 1.34 (95 % CI 0.62-2.90, p = 0.46) or in revision rates OR 3.0 (95 % CI 0.90-10.00, p = 0.74). Meta-regression showed no statistically significant influence of randomization, Jadad score, or assessment of fusion.
  
  
  
  The use of platelet concentrates in spine fusion shows significantly decreased union rates compared with the control group. However, complication and revision rates were not significantly increased. The current data do not recommend the use of platelet concentrate in spine fusion.
authors: Spine Surgery, University Hospital of Basel, University of Basel, Basel, Switzerland. julia.vavken@gmail.com.
authors: Julia
authors: J
authors: Vavken
authors: Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.|Center for Population and Development Studies, Harvard School of Public Health, Boston, MA, USA.|Orthopedic Department, University Hospital of Basel, University of Basel, Basel, Switzerland.|Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, 319 Longwood Ave, Boston, 02115, MA, USA.
authors: Patrick
authors: P
authors: Vavken
authors: Orthopedic Department, Kantonsspital Baden, Baden, Switzerland.
authors: Alexander
authors: A
authors: Mameghani
authors: Orthopedic Department, University Children's Hospital, Basel, Switzerland.
authors: Carlo
authors: C
authors: Camathias
authors: Spine Surgery, University Hospital of Basel, University of Basel, Basel, Switzerland.
authors: Stefan
authors: S
authors: Schaeren
mesh_terms: D000328:Adult; D002986:Clinical Trials as Topic; D006801:Humans; D008875:Middle Aged; D017713:Platelet Transfusion / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology*; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data
keywords: Complications; Fusion; Platelet concentrate; Spine; Union rate