The use of bioabsorbable implants in the spine.
BACKGROUND
Bioabsorbable implants are commonplace in sports medicine surgeries, especially in shoulder and knee ligamentous reconstruction. Their use is now expanding to the realm of spinal reconstructive surgery. Newer polymers offer reduced incidence of the side effects of aseptic sterile sinus formation and have appropriate resorption time parameters for spine use. These new bioabsorbable materials confer initial and intermediate-term stability that is adequate for stable bony healing in various applications. The majority of human clinical applications in the spine that have been documented involve bone graft harvest site reconstruction, posterior spinal graft containment, anterior interbody reconstruction and anterior cervical and lumbar spine tension band plating.


OBJECTIVE
The purpose of this review article is to highlight the indications and outcomes of the use of bioabsorbable implants in specific spinal applications.


METHODS
A comprehensive literature review of the English and non-English literature on bioabsorbable implant technology.


METHODS
A comprehensive literature review was performed to gather basic science, animal and human data on the use of bioabsorbable implants in spinal surgery.


RESULTS
Bioabsorbable implants have demonstrated strength and resorption characteristics commensurate with the physiologic and biomechanical requirements of the human spinal axis. Histologic sampling has demonstrated successful time-patterned resorption accompanied by bony replacement and remodeling of intervertebral cage devices in the animal model.


CONCLUSIONS
Bioresorbable compounds appear to have a role in specific spinal reconstructive procedures. Their radiolucent nature improves image assessment of fusion healing, and their time-engineered resorption characteristics allow controlled dynamization in interbody and plate applications. Their widespread use and acceptance may increase dramatically as further research and clinical studies report on their safety and efficacy.
Rothman Institute at Thomas Jefferson University, Department of Orthopaedics, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107, USA. vaccaro3@yahoo.com
Alexander R
AR
Vaccaro
Kush
K
Singh
Regis
R
Haid
Scott
S
Kitchel
Paul
P
Wuisman
William
W
Taylor
Charles
C
Branch
Steven
S
Garfin
D020341:Absorbable Implants; D000818:Animals; D001860:Bone Plates; D001863:Bone Screws; D004867:Equipment Design; D006801:Humans; D016268:Internal Fixators; D011859:Radiography; D013123:Spinal Fusion; D013131:Spine / Q000000981:diagnostic imaging / Q000601:surgery*