Ventral interbody spondylodesis using a new plug-shaped implant.

A new technique for interbody lumbar spondylodesis using a new cancellous metal, plug-shaped construct was performed in 35 cases with spondylolisthesis or lumbar instability. All of these patients have had severe low-back pain for years, some with radicular symptoms and had been treated unsuccessfully for years. In a follow-up study, 28 of these patients were examined after a time-period of 4 to 24 months. According to objective criteria, the clinical results were good in 19 cases, moderate in five cases and poor in one case. The patients' own judgement about the success of the operation was somewhat different: 17 patients judged their condition as good, six as moderate and two as poor. For three patients the follow-up examination was so close to surgery that no judgement can be made. We saw postoperative complications in two cases: one was a fracture of the implant, the other was a deep vein thrombosis. Since the first reports about ventral spondylodesis by CAPENER [4] and BURNS [2] in the years 1932 and 1933 this surgical technique has been under discussion worldwide. This discussion even increased after HORMON [10] published some reports about his experience with this operative treatment in 1948. Since that time, many techniques for the intercorporal fusion of the spine have been reported. These include tibial or iliac bone grafts, sometimes fixed with screws or plates [6, 9, 12, 17, 20]. This article now describes the new surgical technique for ventral spondylodesis, using a new implant for the interbody fusion of the lumbar and sacral spine. In addition, we describe the indications for ventral spondylodesis and report the results of a rather small follow-up study.