Anterior interbody fusion of the cervical spine with coralline hydroxyapatite

Study Design. A nonrandomized, retrospective human study of patients requir ing anterior discectomy and reconstruction from C3 to T1. The pattern of in corporation, presence or absence of disc space collapse, maintenance of cor rection, and clinical outcomes were considered. Objective. To determine the efficacy of coralline hydroxyapatite as a bone replacement in anterior interbody fusions of the cervical spine used in con junction with rigid Plate fixation. Summary of the Background Data. Autograft is the gold standard for anterior interbody fusion of the cervical spine. Reported complication and morbidit y rates with the use of autograft are as high as 21%. Using allograft inste ad of autograft presents numerous problems including lower rates of fusion. Other bone substitutes such as ceramics and polymethylmethacrylate are ine ffective for fusion. Methods. Twenty-six skeletally mature patients underwent anterior decompres sion, stabilization, microdiscectomy, and reconstruction with Pro Osteon 20 0 (Interpore Cross International, Irvine, CA) coralline hydroxyapatite and AO anterior cervical locking plates. Iliac crest autograft, local bone, and allograft were not used. Results. The minimum follow-up period was 2 years (average, 30 months). The re was no evidence of plate breakage, screw breakage, resorption of the imp lant, or pseudarthrosis. Two patterns of incorporation were identified. The implant incorporated totally in 100% of the disc spaces. Average hospital slay was 1.6 days. The average decrease in pain was 75.8%. There was no evi dence of nonunion. Conclusions. The use of Pro Osteon 200 with rigid anterior plating seems pr omising as a bone replacement in the cervical spine. The incorporation rate is exceedingly high, and the complication rate nonexistent.