title: Application of bioabsorbable screw fixation for anterior cervical decompression and bone grafting.
abstract: OBJECTIVE
  To examine the application of bioabsorbable screws for anterior cervical decompression and bone grafting fixation and to study their clinical effects in the treatment of cervical spondylosis.
  
  
  METHODS
  From March 2007 to September 2012, 56 patients, 36 males and 20 females (38-79 years old, average 58.3±9.47 years), underwent a novel operation. Grafts were fixed by bioabsorbable screws (PLLA, 2.7 mm in diameter) after anterior decompression. The bioabsorbable screws were inserted from the midline of the graft bone to the bone surface of the upper and lower vertebrae at 45 degree angles. Patients were evaluated post-operatively to observe the improvement of symptoms and evaluate the fusion of the bone. The Japanese Orthopaedic Association (JOA) score was used to evaluate the recovery of neurological functions.
  
  
  RESULTS
  All screws were successfully inserted, with no broken screws. The rate of symptom improvement was 87.5%. All of the grafts fused well with no extrusion. The average time for graft fusion was 3.8±0.55 months (range 3-5 months). Three-dimensional reconstruction of CT scans demonstrated that the grafts fused with adjacent vertebrae well and that the screws were absorbed as predicted. The MRI findings showed that the cerebrospinal fluid was unobstructed. No obvious complications appeared in any of the follow-up evaluations.
  
  
  CONCLUSIONS
  Cervical spondylosis with one- or two-level involvement can be effectively treated by anterior decompression and bone grafting with bioabsorbable screw fixation. This operative method is safe and can avoid the complications induced by metal implants.
authors.affiliation: The Second Affiliated Hospital of Xi'an Jiaotong University, Department of Orthopedics, Xi'an/Shaanxi Province, PR China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhao
authors.affiliation: The Second Affiliated Hospital of Xi'an Jiaotong University, Department of Orthopedics, Xi'an/Shaanxi Province, PR China.
authors.forename: Xiaowen
authors.initials: X
authors.lastname: Qiu
authors.affiliation: The Second Affiliated Hospital of Xi'an Jiaotong University, Department of Orthopedics, Xi'an/Shaanxi Province, PR China.
authors.forename: Dong
authors.initials: D
authors.lastname: Wang
authors.affiliation: The Second Affiliated Hospital of Xi'an Jiaotong University, Department of Orthopedics, Xi'an/Shaanxi Province, PR China.
authors.forename: Haopeng
authors.initials: H
authors.lastname: Li
authors.affiliation: The Second Affiliated Hospital of Xi'an Jiaotong University, Department of Orthopedics, Xi'an/Shaanxi Province, PR China.
authors.forename: Xijing
authors.initials: X
authors.lastname: He
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D001863:Bone Screws; D016025:Bone Transplantation / Q000295:instrumentation; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D020127:Recovery of Function; D055009:Spondylosis / Q000534:rehabilitation / Q000601:surgery*; D016896:Treatment Outcome