Resorbable Anterior Cervical Plates for Single-Level Degenerative Disc Disease

OBJECTIVE: Resorbable spinal implants have generated increasing interest. There are minimal data in the literature on the use of resorbable anterior cervical plates. The purpose of this study is twofold. First, we present clinical outcomes of anterior cervical decompression and fusion (ACDF) for single-level degenerative disease using the first commercially available resorbable cervical plate. Second, we compare x-ray outcomes, including pseudarthrosis rates and angulation of healing, between patients receiving resorbable plates and a control group of patients receiving titanium plates. METHODS: Twenty-four consecutive patients treated with single-level ACDF using a resorbable anterior cervical plate were prospectively evaluated with minimum 12-month follow-up (mean, 15 mo). As a control group, 93 consecutive patients treated with single-level ACDF using a titanium plate with minimum 1-year follow-up were assessed. RESULTS: Overall outcomes were good in the resorbable plate group at a mean 15 months follow-up. Neck Disability Index scores decreased from a mean of 64.0 to 20.1% at follow-up (P < 0.001). Numerical Rating Scale pain scores decreased from a mean of 8.0 preoperatively to 2.9 at follow-up (P < 0.001). Three cases of pseudarthrosis [three of 24 (12.5%)] were identified in the resorbable plate group compared with two cases in the control group [two of 93 (2.2%)]. This difference was significant (P = 0.047). Angulation was measured on final x-rays using Cobb angles. Patients in the resorbable plate group healed with a mean 4.52-degree kyphosis, whereas patients in the titanium plate group healed with a mean 2.41-degree lordosis (P < 0.001). CONCLUSION: This report describes, to our knowledge, the first series of patients to undergo ACDF with the first commercially available resorbable cervical plate. Healing in kyphosis and pseudarthrosis was significantly more likely with resorbable implants as compared with the use of titanium plating. Although ultimate clinical outcomes were good, x-ray outcomes may be better with the use of titanium plating.