Cervical monosegmental interbody fusion using titanium implants in degenerative, intervertebral disc disease

Over a period of 12 months at the Klinik fur Neurochirurgie (belonging to t he Stadtischen Klinikums Fulda) 54 patients were operated upon after presen ting with cervical radiculopathy or myelopathy in single vertebral segments with intravertebral disc involvement and/or osteochondrosis. The surgical intervention of all patients was carried out microsurgically by the author using a vental approach in accordance with the operative procedure and tech nique as described by Smith and Robinson [59]. In no patient was an additio nal bone plating necessary. Intraoperative data together with postoperative clinical, neurological, and radiological progress controls at 6 weeks and 3 months were, in the frame of a clinical perspective, non-random study, an alysed and evaluated. There were no complications during the operative proc edure or postoperatively, and of note, in no case was there any implant dis location or neurological deterioration. Radicular pain was relieved in 98% of patients. Non-radicular pain - neck and shoulder pain - was eradicated i n 42 patients (78%), improvement achieved in 8 patients (15%) and 4 patient s (7%) still complained of neck pain 3 months postoperatively. Motor radicu lar deficit was completely relieved in 34 of 38 patients (89%) and in 3 pat ients (8%) there was a considerable improvement. Similar figures were obtai ned with relation to radicular sensory deficit. Of 5 patients who presented preoperatively with cervical myelopathy, 3 improved considerably and 2 rem ained unchanged. For all 50 patients fine layer, computer tomographic exami nation of the cervical region with 3-dimensional reconstruction was perform ed immediately postoperatively and at 3 months. All patients showed a corre ct positioning of the implant and either a complete or convincing bony ingr owth between the operated vertebrae. To summarise, the presented clinical a nd radiological study shows the cancellous bone tissue filled, titanium imp lant to be a meaningful and useable alternative to conventional methods of spinal fusion. Essential advantages: (i) Negation of "bone procedure" complications at the iliac crest and neck combined with a simple and safe surgical procedure. ( ii) Reduced hospitalisation time and subsequent treatment costs. (iii) The good biocompatibility of titanium combined with a solid stability at the fu sion site. Despite the excellent initial operative results the absence of long term re sults must be born in mind.