Article
Cervical spinal fusion with PMMA versus titanium-cage – A prospective randomised study
Vergleich der Fusion der HWS nach anteriorer Diskektomie mit Palacos gegen Titancage – eine prospektiv randomisierte Studie
Search Medline for
Authors
Published: | April 23, 2004 |
---|
Outline
Text
Objective
After ventral diskectomy in the cervical spine, the implantation of a spacer is common practice. Titanium cage type spacers are besides bone cement the favoured types of implant. We report about our prospective randomised study to compare PMMA (Palacos®) with the Intromed ZWE (Zwischenwirbel-Ersatzsystem)-Implantat (Intromed Medizintechnik GmbH, D-12526 Berlin).
Methods
Fifty patients were randomised to each group, and had one and two year follow-ups respectively. The mean age was 43 ± 8 years (range 31-61 years) for the PMMA and 43 ± 8 years (range 31-61 years) for the Titanium group. The groups did not differ in male/female, occupation and smoker/ nonsmoker ratio. Besides the clinical investigation with respect to neurological alterations and range of movement, X-rays were taken and the result was determined according to the Odom Scale.
Results
After the minimum follow-up of one year in the PMMA group, 24 patients scored excellent compared to 22 patients in the Titanium group. 16 PMMA-patients and 16 Titanium-patients showed good, 8 PMMA-patients and 10 Titanium-patients showed satisfying and 2 PMMA-patients and 2 Titanium-patients had a bad result on the Odom scale. In 43 Titanium-cases (86%) fusion occurred radiologically as bony bridging around the implant. Significantly lower (p<0.01) was the fusion rate in the PMMA group with 28 cases (56%) united at follow-up.
Conclusions
In comparison to PMMA a higher fusion rate is achieved with the Titanium cage. Nevertheless this does not influence the clinical outcome with overall good to excellent clinical results in both groups.