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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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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

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  • corresponding author Johannes Schröder - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster, 48129 Münster
  • F. Große-Dresselhaus - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster, 48129 Münster
  • C. Schul - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster, 48129 Münster
  • H. Wassmann - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster, 48129 Münster

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.13.03

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0127.shtml

Published: April 23, 2004

© 2004 Schröder et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

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.