gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

International multicenter study on the biomechanical effects and the occurrence of so-called adjacent-segment disease after cervical intercorporal spondylodesis with Polyetheretherketone (PEEK) Implants: initial results after 1-year follow-up

Internationale Multicenter-Studie zu den biomechanischen Auswirkungen und dem Auftreten der so genannten Anschluss-Instabilität nach zervikaler interkorporaler Spondylodese mit Polyetheretherketon (PEEK)-Implantaten: Erste Ergebnisse nach 12-Monats-Follow-Up

Meeting Abstract

  • corresponding author O. Suess - Neurochirurgische Klinik und Hochschulambulanz, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF)
  • S. Suess - Neurochirurgische Klinik und Hochschulambulanz, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF)
  • F. Bode - Neurochirurgische Klinik und Hochschulambulanz, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF)
  • T. Picht - Neurochirurgische Klinik und Hochschulambulanz, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF)
  • L. Weise - Neurochirurgische Klinik und Hochschulambulanz, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF)
  • M. Brock - Neurochirurgische Klinik und Hochschulambulanz, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF)
  • T. Kombos - Neurochirurgische Klinik und Hochschulambulanz, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF)

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSA.07.01

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc175.shtml

Published: April 11, 2007

© 2007 Suess et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: The ventral cervical discectomy is accepted as the operative standard for decompression in cases of degenerative disease of the cervical spine with clinical signs of myelopathy. There is still though a lack of consensus about the necessity of intercorporal fusion after the decompression, as well as about the materials to be used for this.

Methods: Intercorporal spondylodesis with two different PEEK-implants is carried out according to a controlled study protocol in four study-centers in four European countries over a time period of 24 months with a 5-year follow-up. The study question is: how high is the primary postoperative stability in the operated segment, and what is the degree and time-course of the bony fusion? Furthermore, the implant migration, the postoperative range of movement of the cervical spine, the occurrence of sequel instability, and the postoperative clinical course were investigated.

Results: In the first 1 year of follow-up, 54 of the anticipated 200 patients have been evaluated. The monosegmental fusions in this patient group took place in 6 of 54 cases in segment C3/4, in 15 of 54 cases in C 4/5, in 24 of 54 cases in C5/6, and in 9 of 54 cases in C6/7. The VAS-Score, Denis Pain Scale, and JOA-Score course are presented. The radiological exams include the measurement of the sagittal diameter according to Hinck, anteflexion and retroflexion angles, the height on the intervertebral spaces, and the mean total movement amount (C2/3: 14.8°, C3/4: 13.4°, C4/5: 17.9°, C5/6: 24.6°, C6/7: 17.4°). In this preliminary data calculation, an implant migration into the bordering vertebra cover plate could be found in only one case, which led to operative revision. Segmental connection instability has not been observed in any case to date.

Conclusions: A major advantage of PEEK implants is their permeability to X-rays and their mechanical properties that come very close to those of the bone. They demonstrate also a high solidity for higher chemical and temperature resistance and have favorable slide and abraison behavior. The use of PEEK implants on the cervical vertebrae appears to result in a high postoperative stability with low migration tendencies and a clearly lower danger of postfusional connection instabilities. These initial impressions will have to be judged by the long-term follow-up results.