ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 23 of 49
Up
УЖМБС 2018, 3(1): 123–129
https://doi.org/10.26693/jmbs03.01.123
Clinical Medicine

Optimization of Bone Regeneration in Patients with Osteoporotic Compression of Fractures of Vertebral Bodies of Thoracic and Lumbar Localization

Ivchenko D. V. 1, Miroshnikov V. V. 2
Abstract

The purpose of the article is to identify the main factors that determine the development of disorders in compression fractures of vertebral bodies of thoracic and lumbar localization on the background of postmenopausal and senile osteoporosis. This study was initiated for improving the prognostic criteria of the disease on the basis of an integrated assessment of the clinical course of the disease and optimizing treatment by activating reparative bone tissue regeneration according to the analyzed literature sources. Materials and Methods. Depending on the used treatment method, patients were divided into 3 groups: in group 1 (control group) there were 20 patients with compression fractures of vertebrae of thoracic and lumbar localization against a background of postmenopausal and senile osteoporosis, where we used standard methods of therapy. Group 2 (main group) consisted of 20 patients with compression fractures of vertebrae of thoracic and lumbar localization on the background of postmenopausal and senile osteoporosis, in the treatment of which platelet-rich plasma was also used in addition to standard methods of therapy. Results and Discussion. Based on the obtained results of the study, we developed an algorithm for surgical treatment of patients with pathological vertebral fractures on the background of osteoporosis. The choice of the method of surgical treatment depends on: the type of fracture, the level of damage, the degree of loss of bone mineral density, the degree of deformation of the spine, the general somatic state of the patient, the presence of stenosis of the spinal canal and signs of neurological deficit, the severity of the pain syndrome. The introduction of platelet-rich plasma to the area of the bone wound shortens the duration of the healing process, in our opinion, by eliminating the phase of inflammation, low intensification of the phase of formation of tissue-specific elements that are present in large amount in platelet growth factors. Conclusions. In order to accelerate the restoration of damaged bone, we used a platelet-rich plasma in addition to standard therapy, and found a positive effect on compressive fractures of the thoracic and lumbar vertebrae against the background of postmenopausal and senile osteoporosis, which justifies the advisability of further use platelet-rich plasma in clinical practice.

Keywords: Platelet-Rich Plasma, reparative regeneration, osteogenesis, bone remodeling, mineral metabolism, osteoporosis

Full text: PDF (Ukr) 229K

References
  1. Shteynle AV. Posttravmaticheskaya reheneratsiya kostnoy tkani (chast 2). Sibirskiy meditsinskiy zhurnal. 2010; 25 (1): 114–8. [Russian]
  2. Marunich VV, Ipatov AV, Korobkin YuI, ta in. Osnovni pokazniki invalidnosti ta diyalnosti mediko-sotsialnikh ekspertnikh komisiy Ukraini za 2011 rik: analitiko-informatsiyniy dovidnik. Za red RV Bohatirovoi. D: Porohi, 2012. 150 s. [Ukrainian]
  3. Afaunov AA, Usikov VD, Ptashnikov DA, Takhmazyan KK, Dokish MYu. Eksperimentalnoe izuchenie stabilnosti bestsementnoy i tsementnoy implantatsii transpedikulyarnykh vintov v pozvonki s ponizhennoy mineralnoy plotnostyu kostnoy tkani. Travmatolohiya i ortopediya Rossii. 2010; 2: 97-101. [Russian]
  4. Kholodkova OL, Tsyurupa OV, Badyin IYu. Porivnyalna kharakteristika patolohichnikh zmin u mizhkhrebtsevikh diskakh khvostovikh sehmentiv shchuriv za umov modelyuvannya postiynoi asimetrichnoi kompresiyi-distenziyi ta pislya korektsiyi zbahachenoyu trombotsitami plazmoyu. Zdobutki klinichnoi i eksperimentalnoi meditsini. 2015; 4: 66-8. [Ukrainian]
  5. Stanton T. High-concentrate PRP Promotes Healing in Long-Bone Nonunions. [digital resource]. Available from: https://www.aaos.org/News/The_Daily_Edition_of_AAOS_Now/2012/Wednesday,_February_8/AAOS3_2_8/?ssopc=1
  6. Hatakeyama M, Beletti ME, Zanetta-Barbosa D, Dechichi P. Radiographic and histomorphometric analysis of bone healing using autogenous graft associated with platelet-rich plasma obtained by 2 different methods. Oral Surg, Oral Med, Oral Pathol, Oral Radiol and Endod. 2008; 105 (I): el3–el8. https://doi.org/10.1016/j.tripleo.2007.07.033
  7. Akeda K, An HS, Okuma M, Attawia M, Miyamoto K, Thonar EJ, Lenz ME, Sah RL, Masuda K. Platelet-rich plasma stimulates porcine articular chondrocyte proliferation and matrix biosynthesis. Osteoarthritis Cartilage. 2006; 14 (12): 1272–80. https://www.ncbi.nlm.nih.gov/pubmed/16820306. https://doi.org/10.1016/j.joca.2006.05.008
  8. Schwartz-Arad D, Levin L, Aba M. The use of platelet rich plasma (PRP) and platelet rich fibrin (PRP) extracts in dental implantology and oral surgery. Refuat Hapeh Vehashinayim. 2007; 24 (1): 51–55, 84. https://www.ncbi.nlm.nih.gov/pubmed/17615992
  9. Civinini R, Macera A, Nistri L, Redl B, Innocenti M. The use of autologous blood-derived growth factors in bone regeneration. Innocenti Clin. Cases Miner. Bone Metab. 2011; 8 (1): 25-31. https://www.ncbi.nlm.nih.gov/pmc/articles/3230920
  10. Zhao Y, Zhai W. Research progress of platelet­rich plasma in promoting bone regeneration and repairing. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2010; 24 (8): 1004–8. https://www.ncbi.nlm.nih.gov/pubmed/20839454
  11. Chang T, Liu Q, Marino V, Bartold PM. Attachment of periodontal fibroblasts to barrier membranes coated with platelet-rich plasma. Aust Dent J. 2007; 52 (3): 227–33. https://doi.org/10.1111/j.1834-7819.2007.tb00493.x
  12. Chen L, Yang X, Huang G, Song D, Ye XS, Xu H, Li W. Platelet-rich plasma promotes healing of osteoporotic fractures. Orthopedics. 2013; 36 (6): e687-94. https://www.ncbi.nlm.nih.gov/pubmed/23746028. https://doi.org/10.3928/01477447-20130523-10