gms | German Medical Science

65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

11. - 14. Mai 2014, Dresden

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Fusion rates of intervertebral polyetheretherketone and titan cages without bone grafting in posterior interbody lumbar fusion surgery for degenerative lumbar instability

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  • Marcus Czabanka - Department of Neurosurgery, Charité – Universitätsmedizin Berlin, Berlin, Germany
  • Kaye-Marie Buchholz - Department of Neurosurgery, Charité – Universitätsmedizin Berlin, Berlin, Germany
  • Olaf Suess - Department of Neurosurgery, Charité – Universitätsmedizin Berlin, Berlin, Germany; Center for Spine Surgery and Neurotraumatology, DRK Kliniken Westend, Berlin, Germany
  • Theodoros Kombos - Department of Neurosurgery, Charité – Universitätsmedizin Berlin, Berlin, Germany; Department of Neurosurgery, Klinikum Hildesheim, Hildesheim, Germany
  • Johannes Woitzik - Department of Neurosurgery, Charité – Universitätsmedizin Berlin, Berlin, Germany
  • Peter Vajkoczy - Department of Neurosurgery, Charité – Universitätsmedizin Berlin, Berlin, Germany

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMO.11.06

doi: 10.3205/14dgnc066, urn:nbn:de:0183-14dgnc0666

Veröffentlicht: 13. Mai 2014

© 2014 Czabanka 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: Posterior lumbar interbody fusion (PLIF) surgery is a commonly used procedure for degenerative lumbar instability. Locally harvested bone is usually inserted into intervertebral cages to increase fusion rate. The fusion rate of intervertebral cages without bone application remains unknown. The aim was to retrospectively analyze fusion rates of intervertebral polyetheretherketone and titan cages implanted without autologous bone grafting in posterior lumbar interbody fusion surgery using 3D computer tomography scanning.

Method: Forty patients between the age of 43 and 83 years with mono- or bisegmental degenerative instability were included. Polyetheretherketone cages were used in 28 segments in 25 patients (PEEK group) and titanium cages were used in 19 segments in 15 patients (titanium group) undergoing PLIF surgery with pedicle screws. All patients were treated for degenerative lumbar instability assessed by MRI, CT and/or dynamic lumbar x-ray. Primary outcome parameter was radiological fusion rate measured by CT scan at follow-up, secondary parameters included rate of implant failure and adjacent segment disease.

Results: No difference in mean age between groups was identified (PEEK: 69±10 years, titan: 63±12 years). Mean follow-up was 39±13 months in PEEK and 21±10 months in titan group. Radiological fusion rate was 25% of operated segments in the PEEK group and 47% in the titan group. Screw loosening / adjacent level disease were observed in 8% / 8% in the PEEK group and in 7% / 14% in the titan group.

Conclusions: Radiological fusion rates of PEEK and titan cages without bone grafting are low in PLIF surgery and therefore bone grafting should be performed if possible. Rate of implant failure and adjacent level disease remains low despite reduced osseous fusion in the operated segments.