Abstract
Introduction
Recently ventral plating implants made of carbon/PEEK composite material have been developed with apparently superior material properties in terms of implant fatigue and imaging suitability. In this study we assessed the outcome of the first clinical application of this new implant.
Methods
Retrospective, single-center case series of 16 consecutive patients between 2011 and 2013 undergoing ventral stabilization surgery with a new carbon plating system (see figure 1).
We collected data in terms of safety of the procedure (screw positioning, blood loss, operation time), quality and reliability of the implant (revisions, dislocations, screw loosening, fusion, adjacent segment degeneration), clinical outcome and biological tolerance (cervical pain / discomfort, dysphagia).
Results
All patients were available for clinical and radiological follow up. Mean surgery time was 128 minutes, in 11 cases one in 5 cases 2 segments were treated. The clinical findings and patient's satisfaction were good in 14 and fair in two cases. All patients who completed the 6 months control had a radiographically confirmed interbody fusion; no implant loosening or failure and no infections were observed. (see figure 2)
There was one implant related complication (dysphagia due to malpositioning of the plate which was removed 4 days after implant insertion) and one complication related to the approach (Horner's syndrome).
Conclusion
In this retrospective study of 16 patients we found that the use of a carbon-composite plating system lead to results comparable to the “gold standard” metal plates in terms of safety / clinical outcome and reliability of the implant. There was one revision due to dysphagia.
The MR imaging of the patients who have been operated with the carbon/PEEK system showed superior quality with reduced artifacts and improved diagnostical properties, especially when evaluating the neurogical structures. (see figure 3)
The overall clinical outcome and patient acceptance of the implant was good.
The radiologic findings on follow up of 2, 6 and 12 months have shown a high fatigue strength with no signs of implant failure in terms of dislocation, loosening or breakage. Therefore we conclude that the use of the carbon/PEEK plating system is suitable for ventral stabilization in trauma and degenerative disease.
