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Utility of new bioabsorptive screws in cervical anterior fusion.

Kim K, Isu T, Sugawara A, Matsumoto R, Isobe M

Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido 085-8533, Japan. kyongson@nms.ac.jp

BACKGROUND: The aim of this study is to report our use of new bioabsorbable screws in cervical anterior fusion. These screws need not be removed because they are completely absorbed by resolution in vivo. We describe our method and the new bioabsorbable screws. METHODS: We used PLLA screws until September 2004 and uncalcined uHA-PLLA screws thereafter. They are completely absorbed by resolution to water and carbon dioxide upon in vivo hydrolysis. The uHA-PLLA screws are x-ray impenetrable, and their uHA content renders them osteoconductive. In cervical anterior fusion, the graft is inserted in the area of deletion resulting from decompression. The screws are inserted in the 4 corners of the vertebral body and graft. In long fusion, they are introduced in the 2 lateral wings of the bone graft on each vertebral body and in the 4 corners. Our method eliminates the need for plates or mesh. RESULTS: We have used this method in 62 patients and encountered no complications. There were no screw or graft extrusions and no surgery-related infections. The patients were able to walk a few hours after the operation and wore a simple neck collar for a few days. CONCLUSIONS: This safe and easy method shortens the hospital stay and reduces the risk of graft extrusion and complications associated with the use of nonabsorbable devices.

Published 27 August 2007 in Surg Neurol, 68(3): 264-8; discussion 268.
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