Kemmesies D, Meier U
Neurochirurgische Klinik, Humaine Klinikum Bad Saarow, Germany.
Zentralbl Neurochir. 2005 Feb;66(1):24-33; discussion 34. doi: 10.1055/s-2004-836237.
The ventral spondylodesis with autologeous bone graft for degenerative disease of the cervical spine bears the disadvantage of complications and heavy pain at the superior pelvic straight. To reduce these problems the intervertebral disc spacer was developed. Between September 1997 and January 2002 we operated on 207 patients suffering from degenerative disease -- osteochondrosis and/or disc prolapse -- of the cervical spine. Without any patient selection, e. g. according to a randomized sample, we implanted the different disc spacer by a ventral approach after microsurgical discectomy and removal of the dorsal osteophytes by a high-speed drill. The Titanium disc spacer by Aesculap, Weber, Intromed, and Medinorm were used in 66, 54, 52 and 18 cases and the Carbonium disc spacer of AcroMed in 17 cases. We evaluated the handling, X-ray contrast, costs of implantation and the clinical results after 3 months and 1 year. All the five disc spacers are suitable for the ventral spondylodesis of the cervical spine. The titanium spacer from Weber is characterized by its comfortable handling and a price in the mean range. A good cost effectiveness and an easy handling is given by the Intromed-cage. The X-ray contrast of the Carbonium spacer by AcroMed is insufficient in the lower cervical spine. The handling is good, but the price is too high. The AcroMed, Medinorm and Intromed spacer have the tendency to migrate into the vertebral endplates. A final statement can only be given after the achievement of long-term results.
采用自体骨移植进行颈椎退变疾病的前路椎体融合术存在并发症以及上骨盆直肌处剧痛等缺点。为减少这些问题，研发了椎间盘间隔器。1997年9月至2002年1月期间，我们对207例患有颈椎退变疾病（骨软骨病和/或椎间盘突出）的患者进行了手术。在没有任何患者选择标准（例如根据随机样本）的情况下，我们在显微椎间盘切除术后通过前路植入不同的椎间盘间隔器，并使用高速钻头去除背侧骨赘。Aesculap、Weber、Intromed和Medinorm的钛制椎间盘间隔器分别用于66例、54例、52例和18例，AcroMed的碳质椎间盘间隔器用于17例。我们评估了其操作性、X线显影、植入成本以及3个月和1年后的临床结果。所有这五种椎间盘间隔器均适用于颈椎前路椎体融合术。Weber的钛制间隔器操作性舒适，价格处于中等范围。Intromed椎间融合器具有良好的性价比且操作简便。AcroMed的碳质间隔器在下颈椎的X线显影不足。其操作性良好，但价格过高。AcroMed、Medinorm和Intromed间隔器有向椎体终板迁移的趋势。只有在获得长期结果后才能给出最终结论。
