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Long-term magnetic resonance imaging evaluation of bioresorbable anterior cervical plate resorption following fusion for degenerative and traumatic disk disruption.

Vaccaro AR, Sahni D, Pahl MA, Harrop JS, Sharan AD, Venger BH, Haid RW, Carrino JA, Vadera S, Hilibrand AS, Albert TJ

Department of Orthopedic Surgery, Thomas Jefferson University, Rothman Institute, Philadelphia, PA 19107, USA. alexvaccaro3@aol.com

STUDY DESIGN: A retrospective magnetic resonance imaging (MRI) review of a series of patients who underwent a single-level anterior cervical discectomy and fusion followed by anterior plate stabilization using an anterior cervical resorbable mesh plate and screw system. OBJECTIVE: MRI evaluation of the long-term implant resorption properties of a bioresorbable anterior cervical plate and the adjacent peri-implant soft tissue environment. SUMMARY OF BACKGROUND DATA: The use of bioresorbable anterior cervical plates for immediate cervical stabilization following an anterior cervical discectomy and fusion presents several distinct advantages over metallic instrumentation. Bioresorbable polymers may diminish, by their resorbability, implant-related complications such as loosening, migration, and failure of instrumentation, as well as stress shielding of the underlying fusion. Information on the intermediate and long-term bony and soft tissue reaction to the resorption byproducts of these biomaterials is limited. METHODS: There were 9 consecutive patients who underwent single-level anterior cervical decompression and fusion using allograft cortical bone, followed by bioresorbable polylactide anterior mesh plate and screw fixation. Following institutional review board approval, 5 of the 9 patients agreed to postoperative MRI assessment of the peri-implant area. An independent radiologist then characterized implant degradation, and the presence of soft tissue inflammation and swelling during the resorption phase of the bioresorbable plate. RESULTS: At an average follow-up of 32 months, MRI assessment showed no evidence of soft tissue swelling or inflammation related to the resorption of a bioresorbable anterior plate in any of the 5 patients. In addition, none of the patients complained of any dysphagia or phonation difficulties. CONCLUSIONS: Based on MRI assessment, these devices, at more than 2-year follow-up, did not indicate any local chronic inflammation or swelling resulting from their degradation. Clinical symptoms of dysphagia or dysarthria, a common reported problem following anterior cervical spine procedures, were not observed in any patient.

Published 17 August 2006 in Spine, 31(18): 2091-4.
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