D Kemmesies | PubMed Health

PubMed2005

Experience with five different intervertebral disc spacers for cervical spondylodesis.

The ventral spondylodesis with autologeous bone graft for degenerative disease of the cervical spine bears the disadvantage of complications and heavy pain at the superior pelvic straight. To reduce these problems the intervertebral disc spacer was developed. Between September 1997 and January 2002 we operated on 207 patients suffering from degenerative disease -- osteochondrosis and/or disc prolapse -- of the cervical spine. Without any patient selection, e. g. according to a randomized sample, we implanted the different disc spacer by a ventral approach after microsurgical discectomy and removal of the dorsal osteophytes by a high-speed drill. The Titanium disc spacer by Aesculap, Weber, Intromed, and Medinorm were used in 66, 54, 52 and 18 cases and the Carbonium disc spacer of AcroMed in 17 cases. We evaluated the handling, X-ray contrast, costs of implantation and the clinical results after 3 months and 1 year. All the five disc spacers are suitable for the ventral spondylodesis of the cervical spine. The titanium spacer from Weber is characterized by its comfortable handling and a price in the mean range. A good cost effectiveness and an easy handling is given by the Intromed-cage. The X-ray contrast of the Carbonium spacer by AcroMed is insufficient in the lower cervical spine. The handling is good, but the price is too high. The AcroMed, Medinorm and Intromed spacer have the tendency to migrate into the vertebral endplates. A final statement can only be given after the achievement of long-term results.

Adult↗

PubMed2004

[Experiences with six different intervertebral disc spacers for spondylodesis of the cervical spine].

Spondylodesis of the cervical spine with autologous bone in cases of degenerative disease is associated with pain and complications in the os ilium region. Can this problem be solved when using intervertebral disc spacers? Between September 1997 and January 2003, 267 patients with degenerative disease of the cervical spine were treated operatively and monitored in a follow-up examination. In osteochondrosis of the cervical spine and/or disc herniation, we performed a discectomy using a ventral approach and removed dorsal osteophytes with a high-speed drill. The choice of the six different spacers was randomized. We used 66 titanium disc spacers manufactured by Aesculap, 54 titanium disc spacers by Weber, 52 titanium disc spacers by Intromed, 18 Wing spacers by Medinorm, 17 carbonium spacers by AcroMed, and 50 PEEK spacers by Intromed and did follow-up examinations after 3 and 12 months, respectively. The titanium spacer manufactured by Weber is characterized by good handling and a moderate price. The titanium cage from Intromed has the lowest price and good handling characteristics during operation. The X-ray contrast of the carbonium spacer made by AcroMed is not always sufficient for safe implantation, especially in the lower cervical spine. Handling is good, but the price is too high. The AcoMed, Medinorm, and Intromed titanium spacers show a tendency for penetrating ground plates of adjacent vertebra. The titanium cage Cespace manufactured by Aesculap has good handling characteristics and a moderate price. The PEEK spacer from Intromed can be implanted safely but shows a tendency for dislocation. Long-term results are yet to be reported.

Adult↗