gms | German Medical Science

63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

13. - 16. Juni 2012, Leipzig

Radiographic assessment and outcome after ventral discectomy and implantation of cage or PMMA

Meeting Abstract

  • J.H. Klingler - Abteilung für Allgemeine Neurochirurgie, Neurozentrum, Universitätsklinikum Freiburg
  • M.T. Krüger - Abteilung für Allgemeine Neurochirurgie, Neurozentrum, Universitätsklinikum Freiburg
  • R. Sircar - Abteilung für Allgemeine Neurochirurgie, Neurozentrum, Universitätsklinikum Freiburg
  • E. Kogias - Abteilung für Allgemeine Neurochirurgie, Neurozentrum, Universitätsklinikum Freiburg
  • C. Scheiwe - Abteilung für Allgemeine Neurochirurgie, Neurozentrum, Universitätsklinikum Freiburg
  • U. Hubbe - Abteilung für Allgemeine Neurochirurgie, Neurozentrum, Universitätsklinikum Freiburg

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocDO.13.03

DOI: 10.3205/12dgnc116, URN: urn:nbn:de:0183-12dgnc1164

Veröffentlicht: 4. Juni 2012

© 2012 Klingler et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: To assess fusion rates and quality of life in patients with cervical degenerative disc disease (DDD) after ventral discectomy with different disc substitutes.

Methods: 126 of 175 patients with cervical DDD operated in a single center between 01/2005 and 02/2009 agreed to participate in the study. Of these, 19 patients were excluded due to previous cervical surgery, cervical DDD of level C7/Th1, or ventral discectomy of more than two cervical levels. 39 patients (50 levels) with cervical cage, 38 patients (49 levels) with Sulfix® PMMA dowel, and 32 patients (43 levels) with Palacos® PMMA dowel were analyzed retrospectively. We determined bony fusion of the operated level, graft subsidence, segmental Cobb angle, absolute rotation angle and alignment of the cervical spine in X-rays and CT scans with a follow-up not less than nine months. Clinical outcome was determined with NRS pain, NDI and SF-36 at follow-up.

Results: After a mean follow-up of 2.5 years, fusion was achieved in 65% (cage = C), 57% (Sulfix = S), and 45% (Palacos = P) with statistically significant difference between the cage and Palacos group (p < 0.05). Subsidence and loss of segmental Cobb angle was highest in the cage group. NDI was 27 ± 16% (C), 35 ± 17% (S), and 27 ± 19% (P) with statistically significant difference between the cage and Sulfix group (p < 0.05). NRS pain with 3.1 ± 2.0 (C), 3.6 ± 2.2 (S), and 3.0 ± 2.8 (P), and SF-36 Component Summaries did not reveal any statistically significant differences. Physical Function (SF-36) of 68 ± 24 (C), 50 ± 28 (S), and 61 ± 25 (P) showed statistically significant difference between the cage and Sulfix group (p < 0.05). Revision surgery for dislocated implants was necessary in 1/39 (C), 0/38 (S), and 2/32 (P) patients.

Conclusions: Highest fusion rates but also highest subsidence rates were observed after cage implantation. For clinical outcome, no clear advantageous disc substitute could be specified; however, the cage group appeared to present better function in comparison to the Sulfix group.