Experiences with six different intervertebral disc spacers for spondylodesis of the cervical spine

Abstract

Spondylodesis of the cervical spine with autologous bone in cases of degenerative disease is associated with pain and complications in the os ilium region. Can this problem be solved when using intervertebral disc spacers? Between September 1997 and January 2003, 267 patients with degenerative disease of the cervical spine were treated operatively and monitored in a follow-up examination. In osteochondrosis of the cervical spine and/or disc herniation, we performed a discectomy using a ventral approach and removed dorsal osteophytes with a high-speed drill. The choice of the six different spacers was randomized. We used 66 titanium disc spacers manufactured by Aesculap, 54 titanium disc spacers by Weber, 52 titanium disc spacers by Intromed, 18 Wing spacers by Medinorm, 17 carbonium spacers by AcroMed, and 50 PEEK spacers by Intromed and did follow-up examinations after 3 and 12 months, respectively. The titanium spacer manufactured by Weber is characterized by good handling and a moderate price. The titanium cage from Intromed has the lowest price and good handling characteristics during operation. The X-ray contrast of the carbonium spacer made by AcroMed is not always sufficient for safe implantation, especially in the lower cervical spine. Handling is good, but the price is too high. The AcoMed, Medinorm, and Intromed titanium spacers show a tendency for penetrating ground plates of adjacent vertebra. The titanium cage Cespace manufactured by Aesculap has good handling characteristics and a moderate price. The PEEK spacer from Intromed can be implanted safely but shows a tendency for dislocation. Long-term results are yet to be reported.