The preliminary clinical application of bioresorbable anterior cervical plate system in single-level cervical spondylopathy

English Keywords:Cervical spondylosis  Bioresorbable plate  Titanium alloy  Anterior cervical decompression  Imaging artifacts  Dysphagia

English Abstract:

  【Abstract】 Objectives: To evaluate the outcome of the preliminary clinical application of bioresorbable anterior cervical plate system in single-level cervical spondylopathy. Methods: This was a retrospective cohort study. Thirty patients of cervical spondylopathy from June 2013 to September 2013 underwent sigle-level anterior cervical discectomy and fusion(ACDF). Fifteen cases(5 with cervical spondylotic radiculopathy and 10 with myelopathy) underwent traditional titanium alloy plate system and the other 15 patients(6 with cervical spondylotic radiculopathy and 9 with myelopathy) underwent bioresorbable plate system. There was no significant difference in age, gender, type of cervical spondylosis or level of disease between two groups(P>0.05). X-plain films in anteroposterior, lateral and extension-flexion position and MRI were performed before and after operation. The cervical lordosis and intervertebral disc height were recorded. The fusion time and rates, the fracture and shift of the internal fixation, and the imaging artifacts on MRI were evaluated. The duration of dysphagia was recorded and neurologic function was evaluated by using the visual analogue scale(VAS), the Japanese Orthopeadic Association(JOA) scoring system and JOA recovery rate. The postoperative follow-up time was 2, 6 and 12 months(X-ray was performed once a month to manifest the fusion time). Results: 2 cases presented with dysphagia in titanium group and 1 case in bioresorbable group at 1 day after operation, and all disappeared 2 months after operation. The bioresorbable anterior plate system had small imaging artifacts compared with titanium group. The JOA scores at 12 months after operation significantly increased compared with the preoperative results in both groups(15.9±1.4 ＆ 9.0±1.9 points for titanium group and 16.1±1.0 ＆ 9.7±1.9 points for bioresorbable group, P<0.05 respectively), but the JOA recovery rate was similar(P＞0.05). The VAS had also a significant improvement in two groups(from 7.5±1.2 to 0.6±0.7 points and 6.9±0.9 to 0.5±0.5 points). One patient was noted nonfusion at 12 months after operation in titanium group, with fusion rate of 93.3% and fusion time of 7.8±0.4 months(7-8 months). All the patients in bioresorbable group had a good fusion at last follow-up, with fuison rate of 100% and fusion time of 7.4±0.5 months(7-8 months). There was no significant difference in the fusion rate and fusion time between two groups. There was no significant difference in cervical lordosis and intervertebral height at last follow-up between two groups. There was no fracture or shift of internal fixation in all patients. Conclusions: Bioresorbable anterior cervical plate system for anterior decompression and fusion is reliable, which decreases the imaging artifacts but does not increase the rate of dysphagia due to degradation implant.