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Results of New Absorbable Plate for Neck Fusion
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Posted on: 01/19/2006
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Scientists are working to find ways to replace titanium plates used in cervical fusion. They are looking for something that the body can absorb later. In this report researchers review the current anterior cervical plates (ACP) used. They also give the results of a new bioabsorbable ACP used in seven human cadavers.
Currently titanium plates are used in many cervical fusions. Titanium plates give good stability. Some studies suggest there's too much fixation with titanium. They say this because increased arthritis occurs on either side of the fused segment when titanium is used. They do have a low rate of infection, fracture, and loose screws. It is hard to get a good MRI scan of the surgical site with the plates in the way.
The authors point out some basics that a new type of plate must have. It must have better fusion rates than when bone graft is used by itself (otherwise, why bother adding the plate?). It must stay in place and not shift or move. The plate must hold up under its share of the load while the fusion is taking place.
Beyond that, a bioabsorbable plate must be resorbed by 18 months. MR imaging must be able to "see" through it. In other words, the implant is transparent. It has to hold up under stress and load while the plate and screws bend and then disappear during the resorption process. Finally nothing should be left to block the segment from moving above or below the fused site.
The MacroPore plate tested was made out of resorbable polylactide polymers. Results were compared to titanium plates and the MacroPore mesh plates. The authors report the new MacroPore ACPs can resist load as well as metal plates and better than the mesh plates. The results didn't show if the MacroPore ACP can give the same amount of stability as the titanium plates. More studies are needed before results are final.
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References:
Christopher P. Ames, MD, et al. Biomechanical Analysis of a Newly Designed Bioabsorbable Anterior Cervical Plate. In Journal of Neurosurgery:Spine. December 2005. Vol. 3. No. 6. Pp. 465-470.
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