Document Detail


Bioabsorbable anterior cervical plating: initial multicenter clinical and radiographic experience.
MedLine Citation:
PMID:  17471089     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: Prospective clinical trial. OBJECTIVE: The authors present their initial multicenter experience in the surgical management of 1-level degenerative disc disease of the cervical spine with anterior cervical discectomy and fusions (ACDF) using a bioabsorbable polymer plate. SUMMARY OF BACKGROUND DATA: The introduction of a radiolucent bioabsorbable polymer plate and screws for ACDF presents a novel opportunity to gain the some of the potential added benefit of stabilization with internal immobilization while possibly reducing some of the long-term complications and imaging artifacts associated with titanium instrumentation. We prospectively analyze 52 patients who were treated at 6 different institutions across the United States with bioabsorbable polymer plate and screws for ACDF surgery. METHODS: Patients were prospectively enrolled. A retrospective review of patients' charts and imaging was performed to determine clinical and radiographic outcome following anterior cervical spine surgery. Specifically, the authors looked at need for additional surgeries, local reaction to bioabsorbable polymer, fusion rate, and complications. Surgeries involved the C4-C5, C5-C6, C6-C7, and/or C7-T1 levels. Cadaveric bone was used in 42 patients, polyetheretherketone (PEEK) cages in 6 patients, and iliac crest autograft in 4 patients. The patients were observed for an average of 13.3 months. RESULTS: Radiographic fusion was achieved in 98.1% (51 of 52 patients) of the cases at 6 months. One patient has evidence of nonunion on flexion-extension imaging but remains asymptomatic. A different patient developed mild kyphosis after surgery and had persistence of radicular symptoms but refused further surgery. There were no clinical signs or symptoms of reaction to the bioabsorbable material. CONCLUSIONS: The rates of fusion following single-level ACDF with internal fixation using bioabsorbable polymer plate and screws in this study match those previously reported in the literature with metallic implants and are superior to noninstrumented fusions. Preliminary results suggest that this newly available technology for anterior fusion may be as effective as traditional titanium plating systems in single-level disease. The bioabsorbable material appears to be well tolerated by patients. A larger, randomized, controlled study is necessary to bring the results to statistical significance.
Authors:
Henry E Aryan; Daniel C Lu; Frank L Acosta; Roger Hartl; Patrick W McCormick; Christopher P Ames
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study    
Journal Detail:
Title:  Spine     Volume:  32     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-01     Completed Date:  2007-05-23     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1084-8     Citation Subset:  IM    
Affiliation:
Department of Neurological Surgery, University of California, San Francisco, CA, USA. DrAryan@DrAryan.com
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MeSH Terms
Descriptor/Qualifier:
Absorbable Implants*
Adult
Aged
Bone Plates*
Bone Screws
Bone Transplantation
Cadaver
Cervical Vertebrae / radiography,  surgery*
Diskectomy
Female
Humans
Intervertebral Disk Displacement / radiography,  surgery*
Ketones
Male
Middle Aged
Polyethylene Glycols
Postoperative Complications / prevention & control
Prospective Studies
Spinal Fusion / methods*
Thoracic Vertebrae / radiography,  surgery
Transplantation, Homologous
Treatment Outcome
Chemical
Reg. No./Substance:
0/Ketones; 0/Polyethylene Glycols; 31694-16-3/polyetheretherketone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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