Interest of porous biomaterials in spinal surgery

PURPOSE OF THE STUDY: The aim of this work was to study the behavior of porous alumina ceramic cages in spinal cervical surgery, with or without plate fixation as needed. MATERIAL AND METHODS: The population included 61 patients who underwent spinal surgery between May 1999 and October 2003. There were 48 women and 13 men, mean age 49 years at surgery. 74 implants were used, among them 71 were interbody cages. Ten patients were operated at two levels; C5-C6 and C6-C7 were most frequently instrumented. Patients were reviewed at 1 month, 3 months and 6 months, and, whenever possible more after. Clinical and radiological data were available for all patients. RESULTS: Mean follow-up was 7.2 months. Postoperative clinical data included assessment of neck and arm pain, using a visual analogic scale and fusion status determined by the presence of trabecular bridging bone and the disappearance of lucent lines around the implant on plain anteroposterior and lateral cervical radiographs. Two patients required another intervention, allowing intra-operative assessment of the quality of fusion. Clinical results were in agreement with the usual outcome reported in the literature with 54% of patients free of postoperative neck or arm pain and restriction of function mild or absent in 88%. Bone healing was achieved at 6 months on the average in 58 cases and in all patients at 12 months, including the two patients who required revision. DISCUSSION: The porous alumine cage is a reliable biocompatible and mechanically stable element helpful for achieving bone healing. Integration into bone tissue was radiographically satisfactory. This kind of implant appears to be an attractive alternative in spinal cervical surgery, avoiding donor graft site complications.