gms | German Medical Science

Depending on clinical symptomatology the target is a phase-justified operative reconstruction for isolated osteochondrosis of the lower lumbar spine.

An implant has been developed for an exclusive anterior intercorporeal spondylodesis in terms of an adjusted segmental reconstruction. The implant allows for an endoscopic as well as for an open implantation. Special instrumentation for endoscopic use has been developed. Initially, a one-piece spacer with a three-dimensional porous structure, Spongiosa Metal^® II, for distraction spondylodeses was developed. Further research and development resulted in an elastic spacer with silicone core for an elastic anterior spondylodesis as further development. Both spacer versions are available in different lengths, diameters and shapes respecting the segments to be treated. Identical contraindications apply for the elastic spacer as for other metal spacer systems. The elastic spacer without silicone core has been implanted in 15 patients up to now, eleven of them endoscopically (changing from endoscopy to open procedure in three cases), four patients by laparotomy; twice a two-segmental spondylodesis was performed.

Complications: one retrograde ejaculation; one spacer loosening.

Clinical results correspond to other fusion procedures and depend on the indication and the selection of patients. According to the present biomechanical test protocol the elastic spacer shows no damaging on a load simulator which could be ascribed to the metallic base and the silicone buffer. After the approval of the ethical application by the ethical committee of the regional medical association Thüringen and by the University of Göttingen the elastic spacer can be implanted.