Resorbable polylactic acid interbody spacers with vertebral autograft for anterior cervical discectomy and fusion

Michael Y. Wang, Charles Y. Liu

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

OBJECTIVE: Resorbable polylactic acid spinal implants have recently become commercially available. These spacers carry the advantages of allowing for clear visualization of new bone growth, eliminating the risk of pathogen transmission, and providing for consistent biomechanical quality. However, previously published reports on the use of these spacers have all utilized bone morphogenetic proteins to supplement the fusion. This report describes our early experience with the use of these devices for interbody reconstruction in anterior cervical discectomy with fusion. METHODS: Twenty patients underwent an anterior cervical discectomy with fusion at 30 levels during an 18-month period. All patients were implanted with polylactic acid interbody spacers using the Smith-Robinson technique. Supplementary anterior cervical plating was applied using unicortical semiconstrained screws, and the spacers were filled with vertebral endplate autograft bone shavings. Seven of the patients were smokers, and three were diabetics. Radiographic fusion was determined with dynamic cervical spine x-rays, and clinical responses were determined using the Medical Outcomes Study Short-Form 36-Item Health Survey, Odom's criteria, Nurick scores, and functional outcome swallowing score dysphagia scores. Follow-up averaged 11.6 months. RESULTS: Of the 9 patients with myelopathy, all experienced clinical improvement, with the mean Nurick score improving from 2.7 to 1.3. Of the 14 patients who had radiculopathy, 9 had complete resolution of symptoms, 4 experienced some improvement, and 1 had no improvement. All 20 patients demonstrated radiographic fusion at last follow-up as demonstrated by bridging bone between the vertebral bodies and the absence of motion on dynamic x-rays. CONCLUSION: Resorbable polylactic acid interbody spacers are safe and effective for anterior cervical discectomy and fusion. Use of locally harvested vertebral endplate bone packed within the spacer is sufficient to promote fusion in anterior cervical discectomy with fusion.

Original languageEnglish
Pages (from-to)135-140
Number of pages6
JournalNeurosurgery
Volume57
Issue number1
DOIs
StatePublished - Jul 1 2005
Externally publishedYes

Fingerprint

Diskectomy
Autografts
Bone and Bones
X-Rays
Bone Morphogenetic Proteins
Radiculopathy
Infectious Disease Transmission
Spinal Cord Diseases
Bone Development
Deglutition
Deglutition Disorders
Health Surveys
poly(lactic acid)
Spine
Outcome Assessment (Health Care)
Equipment and Supplies

Keywords

  • Anterior cervical discectomy
  • Cervical radiculopathy
  • Cervical spine
  • Myelopathy
  • Polylactic acid
  • Resorbables

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Resorbable polylactic acid interbody spacers with vertebral autograft for anterior cervical discectomy and fusion. / Wang, Michael Y.; Liu, Charles Y.

In: Neurosurgery, Vol. 57, No. 1, 01.07.2005, p. 135-140.

Research output: Contribution to journalArticle

@article{32a60fcb710f4fcdb6391ef121ebb9e8,
title = "Resorbable polylactic acid interbody spacers with vertebral autograft for anterior cervical discectomy and fusion",
abstract = "OBJECTIVE: Resorbable polylactic acid spinal implants have recently become commercially available. These spacers carry the advantages of allowing for clear visualization of new bone growth, eliminating the risk of pathogen transmission, and providing for consistent biomechanical quality. However, previously published reports on the use of these spacers have all utilized bone morphogenetic proteins to supplement the fusion. This report describes our early experience with the use of these devices for interbody reconstruction in anterior cervical discectomy with fusion. METHODS: Twenty patients underwent an anterior cervical discectomy with fusion at 30 levels during an 18-month period. All patients were implanted with polylactic acid interbody spacers using the Smith-Robinson technique. Supplementary anterior cervical plating was applied using unicortical semiconstrained screws, and the spacers were filled with vertebral endplate autograft bone shavings. Seven of the patients were smokers, and three were diabetics. Radiographic fusion was determined with dynamic cervical spine x-rays, and clinical responses were determined using the Medical Outcomes Study Short-Form 36-Item Health Survey, Odom's criteria, Nurick scores, and functional outcome swallowing score dysphagia scores. Follow-up averaged 11.6 months. RESULTS: Of the 9 patients with myelopathy, all experienced clinical improvement, with the mean Nurick score improving from 2.7 to 1.3. Of the 14 patients who had radiculopathy, 9 had complete resolution of symptoms, 4 experienced some improvement, and 1 had no improvement. All 20 patients demonstrated radiographic fusion at last follow-up as demonstrated by bridging bone between the vertebral bodies and the absence of motion on dynamic x-rays. CONCLUSION: Resorbable polylactic acid interbody spacers are safe and effective for anterior cervical discectomy and fusion. Use of locally harvested vertebral endplate bone packed within the spacer is sufficient to promote fusion in anterior cervical discectomy with fusion.",
keywords = "Anterior cervical discectomy, Cervical radiculopathy, Cervical spine, Myelopathy, Polylactic acid, Resorbables",
author = "Wang, {Michael Y.} and Liu, {Charles Y.}",
year = "2005",
month = "7",
day = "1",
doi = "10.1227/01.NEU.0000163427.42536.A7",
language = "English",
volume = "57",
pages = "135--140",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Resorbable polylactic acid interbody spacers with vertebral autograft for anterior cervical discectomy and fusion

AU - Wang, Michael Y.

AU - Liu, Charles Y.

PY - 2005/7/1

Y1 - 2005/7/1

N2 - OBJECTIVE: Resorbable polylactic acid spinal implants have recently become commercially available. These spacers carry the advantages of allowing for clear visualization of new bone growth, eliminating the risk of pathogen transmission, and providing for consistent biomechanical quality. However, previously published reports on the use of these spacers have all utilized bone morphogenetic proteins to supplement the fusion. This report describes our early experience with the use of these devices for interbody reconstruction in anterior cervical discectomy with fusion. METHODS: Twenty patients underwent an anterior cervical discectomy with fusion at 30 levels during an 18-month period. All patients were implanted with polylactic acid interbody spacers using the Smith-Robinson technique. Supplementary anterior cervical plating was applied using unicortical semiconstrained screws, and the spacers were filled with vertebral endplate autograft bone shavings. Seven of the patients were smokers, and three were diabetics. Radiographic fusion was determined with dynamic cervical spine x-rays, and clinical responses were determined using the Medical Outcomes Study Short-Form 36-Item Health Survey, Odom's criteria, Nurick scores, and functional outcome swallowing score dysphagia scores. Follow-up averaged 11.6 months. RESULTS: Of the 9 patients with myelopathy, all experienced clinical improvement, with the mean Nurick score improving from 2.7 to 1.3. Of the 14 patients who had radiculopathy, 9 had complete resolution of symptoms, 4 experienced some improvement, and 1 had no improvement. All 20 patients demonstrated radiographic fusion at last follow-up as demonstrated by bridging bone between the vertebral bodies and the absence of motion on dynamic x-rays. CONCLUSION: Resorbable polylactic acid interbody spacers are safe and effective for anterior cervical discectomy and fusion. Use of locally harvested vertebral endplate bone packed within the spacer is sufficient to promote fusion in anterior cervical discectomy with fusion.

AB - OBJECTIVE: Resorbable polylactic acid spinal implants have recently become commercially available. These spacers carry the advantages of allowing for clear visualization of new bone growth, eliminating the risk of pathogen transmission, and providing for consistent biomechanical quality. However, previously published reports on the use of these spacers have all utilized bone morphogenetic proteins to supplement the fusion. This report describes our early experience with the use of these devices for interbody reconstruction in anterior cervical discectomy with fusion. METHODS: Twenty patients underwent an anterior cervical discectomy with fusion at 30 levels during an 18-month period. All patients were implanted with polylactic acid interbody spacers using the Smith-Robinson technique. Supplementary anterior cervical plating was applied using unicortical semiconstrained screws, and the spacers were filled with vertebral endplate autograft bone shavings. Seven of the patients were smokers, and three were diabetics. Radiographic fusion was determined with dynamic cervical spine x-rays, and clinical responses were determined using the Medical Outcomes Study Short-Form 36-Item Health Survey, Odom's criteria, Nurick scores, and functional outcome swallowing score dysphagia scores. Follow-up averaged 11.6 months. RESULTS: Of the 9 patients with myelopathy, all experienced clinical improvement, with the mean Nurick score improving from 2.7 to 1.3. Of the 14 patients who had radiculopathy, 9 had complete resolution of symptoms, 4 experienced some improvement, and 1 had no improvement. All 20 patients demonstrated radiographic fusion at last follow-up as demonstrated by bridging bone between the vertebral bodies and the absence of motion on dynamic x-rays. CONCLUSION: Resorbable polylactic acid interbody spacers are safe and effective for anterior cervical discectomy and fusion. Use of locally harvested vertebral endplate bone packed within the spacer is sufficient to promote fusion in anterior cervical discectomy with fusion.

KW - Anterior cervical discectomy

KW - Cervical radiculopathy

KW - Cervical spine

KW - Myelopathy

KW - Polylactic acid

KW - Resorbables

UR - http://www.scopus.com/inward/record.url?scp=21744449600&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=21744449600&partnerID=8YFLogxK

U2 - 10.1227/01.NEU.0000163427.42536.A7

DO - 10.1227/01.NEU.0000163427.42536.A7

M3 - Article

C2 - 15987549

AN - SCOPUS:21744449600

VL - 57

SP - 135

EP - 140

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

IS - 1

ER -