gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

Loss of correction does not influence clinical outcome following anterior cervical fusion. Final clinical results of a multicenter randomised controlled study

Meeting Abstract

  • T. Pitzen - Klinik für Wirbelsäulenchirurgie und Neurotraumatologie, SRH Wald-Klinikum Gera
  • J. Drumm - Neurochirurgische Klinik, Universitätsklinikum des Saarlandes, Homburg/Saar
  • J. Chrobok - Neurochirugie, Homolka Krankenhaus, Prag
  • R. Kucera - Wirbelsäulenchirurgie, Motol Krankenhaus, Prag
  • S. Ruffing - Radiologie, Bundesknappschaftsklinik Püttlingen
  • L. Sova - Klinik für Wirbelsäulenchirurgie und Neurotraumatologie, SRH Wald-Klinikum Gera
  • W.I. Steudel - Neurochirurgische Klinik, Universitätsklinikum des Saarlandes, Homburg/Saar

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMO.09-06

DOI: 10.3205/09dgnc058, URN: urn:nbn:de:0183-09dgnc0581

Published: May 20, 2009

© 2009 Pitzen et al.
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Outline

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Objective: Within the first part of a multicenter randomised controlled trial we have shown (and already reported elsewhere), that the use of dynamic versus rigid plates in cervical spine surgery results in faster fusion and lower implant complications if dynamic plates are used. A secondary objective of this study was to investigate loss of correction (segmental lordosis and height) as well as clinical outcome measurements and to analyse if clinical outcome depends of loss of correction.

Methods: 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, Germany, study group) or a rigid plate (CSLP, Synthes, Switzerland, control group). At discharge, after three and six months and finally after two years, loss of lordosis, loss of segmental height, Visual Analogue Scale (VAS) for neck pain and for arm pain and Neck Disability Index (NDI) were recorded. An independent radiologist performed all radiographic measurements.

Results: 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 was significant (p = 0.003). The 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 the control group, these values were 0,5 mm and 1,3 mm (p = 0.001). However, clinical postoperative outcome was not different for any of the asked parameters between the two groups through the postoperative follow-up and there was no significant correlation (as expressed by Spearmann's rho and p-value) for loss of segmental height or lordosis versus any of the clinical parameters.

Conclusions: Loss of segmental lordosis and loss of segmental height are significantly higher if dynamic plates are used. This, however, does not result in differences regarding clinical outcome between dynamic and constrained plates.