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The purpose of this study is to compare the efficacy of the DePuy-Acromed DOC implant with the Synthes AO plate by means of analysis of subjective and objective data.

A retrospective review of 56 consecutive instrumented, anterior multi-level cervical fusions by two orthopedic spine specialists was completed. Biographical, clinical, surgical and radiographic data was collected for patients who underwent anterior multi-level cervical fusions between 12/13/96 and 4/8/99. Twenty-five of the patients received a DOC implant and 31 received the AO plate.

No major complications occurred during or following surgery directly related to either implant. Both groups however, did contain cases of transient dysphasia and lingering pain. Generally, patients that received the DOC implant experienced a greater percent decrease in post-operative pain levels though both study groups exhibited significant improvement. The use of a DOC implant was also correlated with a loss of fewer working days amongst those in the study group. Psuedoarthrosis and a return to pre-operative pain levels occurred in patients using the AO implant at higher frequencies than in those with the DOC. Screw loosening occurred less frequently with the AO plate than with the DOC implant. However, the one case of AO screw loosening required subsequent hardware removal.

The DOC also appears to have the added benefit of offering a dynamic system that can reduce the amount of load shielding of the bone graft during the time that it is fusing.

It appears that the newer DOC implant offers desirable benefits over the traditional AO locking plate. The dysphasia and cost were liabilities that seem to be offset by the patient satisfaction level with surgeries involving the DOC implant.

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