gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Segmental height loss is associated with increased head and neck pain after iliac crest autograft interposition but not after cage interposition in anterior cervical discectomy

Segmentaler Höhenverlust nach ventraler zervikaler Diskektomie ist bei autologem Beckenkamminterponat aber nicht bei Cageinterponat mit verstärkten Kopf- und Nackenschmerzen assoziiert

Meeting Abstract

  • corresponding author C. Thomé - Neurochirurgische Klinik, Universitätsklinikum Mannheim
  • O. Leheta - Neurochirurgische Klinik, Universitätsklinikum Mannheim
  • J. K. Krauss - Neurochirurgische Klinik, Universitätsklinikum Mannheim
  • D. Zevgaridis - Neurochirurgische Klinik, Universitätsklinikum Mannheim

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-10.01

The electronic version of this article is the complete one and can be found online at:

Published: May 4, 2005

© 2005 Thomé et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




The clinical relevance of segmental height loss after anterior cervical discectomy (ACD) is an ongoing matter of debate. The purpose of this study was to investigate the effect of height loss on clinical outcome after interposition of iliac crest autografts (IC) and rectangular titanium cages (RTC).


100 consecutive patients harboring 127 levels of cervical disc disease refractory to adequate conservative treatment were randomized to either IC or RTC fusion. Pain was self-assessed separately for head, neck and arm (VAS; 0-10). Outcome was analyzed using Odom criteria and patient satisfaction. Segmental height loss was defined as subsidence, collapse or dislocation of the implant of more than 2mm on lateral radiographs. Follow-up of 3 and 12 months was available for 98 and 95 patients respectively.


Significant height loss was present in 15 IC patients due to subsidence (3), collapse (8) or dislocation (4) and in 11 RTC patients (subsidence) and occurred during the first few months after ACD. Height loss was not found to influence fusion rates. At 3 months, both IC and RTC patients with segmental height loss reported more residual arm pain (1.9±2.6) than patients without height loss (0.6±1.2; p<0.01). At 12 months, however, this difference was no longer present. In RTC patients, head and neck pain improved comparably regardless of height loss. In IC patients, however, head pain increased in comparison to preoperatively in patients with radiographic height loss (e.g. at 12 months: +0.8±2.0), while it decreased in those without height loss (-1.9±2.9; p<0.01). Neck pain persisted in IC patients with radiographic height loss (-0.1±3.3 vs. -2.3±3.2; p<0.05). This translated in reduced patient satisfaction in IC patients with height loss (p<0.01), while there was no difference in satisfaction of RTC patients in relation to subsidence.


Segmental height loss after ACD was associated with more residual arm pain in the first months, but this difference fainted over time. Segmental height loss in patients with iliac crest autograft interposition was associated with more residual head and neck pain and reduced patient satisfaction. No association between outcome and height loss was found after cage interposition.