Application of bioabsorbable screw fixation for anterior cervical decompression and bone grafting

Abstract

OBJECTIVES: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.

The influence of alloying and fabrication techniques on the mechanical properties, biodegradability and biocompatibility of zinc: A comprehensive review

“…Examples include the Igaki-Tamai, the DESolve, and the ABSORB stents made of poly-L-lactic acid (PLLA) [44]; the Ideal BioStent consisting of salicylic acid/adipic acid (SA/AA); and the REVA stent constructed from tyrosine-derived polycarbonate [14,31]. Reports on the successful application of polymer-based bioabsorbable screws for bone grafting fixation are also available [45].…”

Resorbable Orthopedic Implants in Pediatric Patients: A Narrative Review

“…One such example is the use of bioabsorbable screws for latarjet procedures or anterior cruciate ligament reconstruction [12][13][14]. Other articles have demonstrated an application of bioabsorbable screws for anterior cervical fusion and decompression in treatment of cervical spondylosis [15,16]. One 1996 article mentioned the use of resorbable pins for fracture fixation of small bony fragments [17].…”

Resorbable implants in pediatric fracture treatment

“…The most prominent polymers are poly- l -lactic acid (PLLA) and poly-lactic-co-glycolic acid (PLGA), which are widely considered for use as osteosynthesis and bone grafts [4], [5]. Polymer-based implants are made of sugar derivatives such as PLLA and PLGA, with poor osteoconductivity and mechanical properties (low strength and stiffness, high brittleness).…”