Biodegradable implants in neurosurgery

Background. Biodegradable materials have been used for osteosynthesis by or thopedic surgeons and craniomaxillofacial surgeons for many years. However, such materials are not yet widely used by neurosurgeons despite potential applications. This prospective study was undertaken to evaluate potential a pplications of biodegradable materials in neurosurgical interventions. Methods. A total of 104 4-hole plates and 228 screws consisting of copolyme r of poly-70 L/30 D,L-lactide were inserted for fixation of bone flaps in 8 patients and for reinsertion of laminoplasties at 28 levels in 16. The cra niotomies were performed for removal of a brain tumour in 4 cases, for surg ical management of an aneurysm or cerebral AVM in 2, and for treatment of c raniocerebral trauma in another 2. Laminoplasties were performed at 25 leve ls for intraspinal hemangioblastomas in 15 patients. One patient with an ep endymoma underwent 3-level laminoplasty. Findings. One patient with severe head injury in whom the bone flap was re- implanted several months following the craniectomy, developed an aseptic ne crosis of the bone flap, which had to be removed. Implant rejection was not observed. One patient suffered from mild local pain in the area of a biode gradeable screw in the frontal region following removal of a sphenoid wing meningeoma. None of the patients with laminoplasty showed signs of function al instability or spinal cord compression. Implant rejection was not observ ed. No delayed healing or infection occurred. Healing was not delayed and n o infections occurred. Interpretation. The results encourage further use of biodegradable material s for the described applications. Additional studies will be performed to i nvestigate the usefulness of biodegradable devices in neurosurgery and to o btain long-term results.