title: Osteolysis following resorbable poly-L-lactide-co-D, L-lactide PLIF cage use: a review of cases.
abstract: METHODS
  Report of case series.
  
  
  OBJECTIVE
  To report a problem with bioabsorbable poly-L-lactide-co-D, L-lactide, PLDLLA, posterior lumbar instrumented fusion (PLIF) cage implants.
  
  
  BACKGROUND
  Synthetic bioabsorbable implants have recently been introduced to spinal surgery and their indications and applications are still being explored. There is evidence that the use of bioabsorbable cages may be of benefit in interbody spinal fusion.
  
  
  METHODS
  We present a case series of nine patients who have undergone PLIF with bioabsorbable cages in the lumbar spine.
  
  
  RESULTS
  At follow-up over at least 1 year, four of these patients were found to have osteolysis around the implant on CT scanning. One of these patients underwent an operation to remove the cage and histology sent during surgery suggested that the implant had caused the bone loss and there was no evidence of infection. Another patient had ongoing pain in relation to the lysis, while the other two patients with lysis remained asymptomatic.
  
  
  CONCLUSIONS
  PLDLLA cage, which has high osteolytic nature, is considered not suitable as a fusion cage.
authors: Spine Surgical Unit, Department of Trauma and Orthopaedics, University Hospital North Staffordshire, Newcastle Road, Stoke on Trent, ST4 6QG, UK. frost.andrew@ymail.com
authors: Andrew
authors: A
authors: Frost
authors: Elmanzour
authors: E
authors: Bagouri
authors: Mark
authors: M
authors: Brown
authors: Vinay
authors: V
authors: Jasani
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects* / Q000592:standards; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects* / Q000592:standards; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D011091:Polyesters / Q000009:adverse effects* / Q000592:standards / Q000627:therapeutic use; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000379:methods; D011859:Radiography; D013123:Spinal Fusion / Q000009:adverse effects / Q000295:instrumentation; D013130:Spinal Stenosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*
chemical_list: D011091:Polyesters; C033616:poly(lactide)