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


BACKGROUND
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.
Vaccaro
Alexander R
AR
Department of Orthopedic Surgery, Thomas Jefferson University, Rothman Institute, Philadelphia, PA 19107, USA. alexvaccaro3@aol.com
Sahni
Deshdeepak
D
Pahl
Michael A
MA
Harrop
James S
JS
Sharan
Ashwini D
AD
Venger
Benjamin H
BH
Haid
Regis W
RW
Carrino
John A
JA
Vadera
Sumeet
S
Hilibrand
Alan S
AS
Albert
Todd J
TJ
D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D001860:Bone Plates; D002574:Cervical Vertebrae / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome