Artikel
Fusion, loss of correction and implant complications following anterior cervical plating with dynamic or rigid plates: 2-year results of a multi-centric, randomized, controlled study
Fusionsgeschwindigkeit, Implantatkomplikationen und Korrekturverlust nach ventraler zervikaler Fusion bei dynamischen und rigiden zervikalen Platten: 2-Jahres-Ergebnisse einer multizentrischen, randomisierten, kontrollierten Studie.
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Autoren
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T. Pitzen
- Neurochirurgische Klinik, Universitätskliniken des Saarlandes, Homburg
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J. Drumm
- Neurochirurgische Klinik, Universitätskliniken des Saarlandes, Homburg
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J. Chrobok
- Neurosurgery, Homolka Hospital, Prague, Czech Republic
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R. Kucera
- Neurosurgery, Homolka Hospital, Prague, Czech Republic
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J. Stulik
- Spinal Surgery, University Hospital Motol, Prague, Czech Republic
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T. Vyskocil
- Spinal Surgery, University Hospital Motol, Prague, Czech Republic
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S. Ruffing
- Abteilung für Radiologie, Bundesknappschafts-Klinik Püttlingen, Püttlingen
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L. Sova
- Neurochirurgische Klinik, Bundeswehrkrankenhaus, Ulm
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W. I. Steudel
- Neurochirurgische Klinik, Universitätskliniken des Saarlandes, Homburg
| Veröffentlicht: | 30. Mai 2008 |
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Gliederung
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Objective: The aim of the study was to analyse 1. speed of fusion, 2. loss of correction, and 3. implant complications in both type of plates.
Methods: This is a prospective, randomized, controlled multi-centric study, approved by the ethics committees of each participating country. 132 patients were included and assigned by randomisation to one of the groups in which they received a routine anterior cervical discectomy and autograft fusion with either a dynamic plate (ABC, Aesculap AG+CoKG, Tuttlingen, Germany, study group) or a rigid plate (CSLP, Synthes Spine, Paoli, PA, USA, control group). At discharge, after three and six months and finally after two years, segmental mobility, loss of height and lordosis, and implant complications were studied. All measurements were performed by an independent radiologist. Only parts of the results have already been published.
Results: Mean segmental motility immediately after surgery for the study group was 1.7 mm, 1.4 mm after three months, 0.8 mm after six months, 0.4 mm after two years. For the control group these values were 1.0 mm, 1.8 mm, 1.6 mm and 0.5 mm. The difference at six months between the two groups was significant (p=0.024). Loss of segmental height with respect to intraoperative x-ray was 0.8 mm at discharge and 2.9 mm after two years for the study group. For control group, these values were 0.5 mm, 1.3 mm. The difference at two years is significant (p=0.001). The loss of segmental lordosis with respect to intraoperative x-ray was 1.3° at discharge and 4.3° after two years for the study group. For the control group, these values were 0.9°, 0.7°. The difference at two years is significant (p=0.003). There have been 4 patients with hardware complications within the control group and no implant complications within the study group, p=0.048.
Conclusions: There is evidence that dynamic plate designs provide a significantly more rapid fusion, a significantly lower rate of implant complications; however, the loss of correction is significantly higher when this type of plate is used.
