Follow-up radiographs of the cervical spine after anterior fusion with titanium intervertebral disc

Purpose: We examined the postoperative changes of the cervical spine after treatment of cervical nerve root compression with anterior cervical discect omy and fusion with a new titanium intervertebral disc. Patients and Method s: 37 patients were examined prior to, as well as 4 days, 6 weeks, and 7 mo nths after surgery. Lateral view X-rays and functional imaging were used to evaluate posture and mobility of the cervical spine, the position of the i mplants, and the reactions of adjacent bone structures. Results: Implantati on of the titanium disc led to post-operative distraction of the interverte bral space and slight lordosis. Within the first 6 months a slight loss of distraction and re-kyphosis due to impression of the implants into the vert ebral end-plates were found in all patients. We noted partial infractions i nto the vertebral end-plates in 10/42 segments and slight mobility of the i mplants in 14/42 segments. Both groups of patients showed reactive spondylo sis and local symptoms due to loosening of the implants. The pain subsided after onset of bone bridging and stable fixation of the loosened discs. Con clusions: The titanium intervertebral disc provides initial distraction of the fusioned segments with partial recurrence of kyphosis during the subseq uent course. Loosening of the implants with local symptoms can be evaluated with follow-up X-rays and functional imaging.