Anterior interbody fusion of the cervical spine with coralline hydroxyapatite.
METHODS
A nonrandomized, retrospective human study of patients requiring anterior discectomy and reconstruction from C3 to T1. The pattern of incorporation, presence or absence of disc space collapse, maintenance of correction, and clinical outcomes were considered.


OBJECTIVE
To determine the efficacy of coralline hydroxyapatite as a bone replacement in anterior interbody fusions of the cervical spine used in conjunction with rigid plate fixation.


BACKGROUND
Autograft is the gold standard for anterior interbody fusion of the cervical spine. Reported complication and morbidity rates with the use of autograft are as high as 21%. Using allograft instead of autograft presents numerous problems including lower rates of fusion. Other bone substitutes such as ceramics and polymethylmethacrylate are ineffective for fusion.


METHODS
Twenty-six skeletally mature patients underwent anterior decompression, stabilization, microdiscectomy, and reconstruction with Pro Osteon 200 (Interpore Cross International, Irvine, CA) coralline hydroxyapatite and AO anterior cervical locking plates. Iliac crest autograft, local bone, and allograft were not used.


RESULTS
The minimum follow-up period was 2 years (average, 30 months). There was no evidence of plate breakage, screw breakage, resorption of the implant, or pseudarthrosis. Two patterns of incorporation were identified. The implant incorporated totally in 100% of the disc spaces. Average hospital stay was 1.6 days. The average decrease in pain was 75.8%. There was no evidence of nonunion.


CONCLUSIONS
The use of Pro Osteon 200 with rigid anterior plating seems promising as a bone replacement in the cervical spine. The incorporation rate is exceedingly high, and the complication rate nonexistent.
Thalgott
J S
JS
International Spinal Development and Research Foundation, Las Vegas, Nevada, USA.
Fritts
K
K
Giuffre
J M
JM
Timlin
M
M
D000328:Adult; D000368:Aged; D001860:Bone Plates; D001863:Bone Screws; D018786:Bone Substitutes; D002516:Ceramics; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006882:Hydroxyapatites; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D010147:Pain Measurement; D011859:Radiography; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome
D018786:Bone Substitutes; D006882:Hydroxyapatites; C119955:coralline hydroxyapatite