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Die monosegmentale ventrale Spondylodese mit dem SynFix-LR™

Eine prospektive 2-Jahres-Studie

Monosegmental anterior lumbar interbody fusion with the SynFix-LR™ device

A prospective 2-year follow-up study

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Zusammenfassung

Hintergrund

Durch die alleinige anteriore lumbale intersomatische Fusion (ALIF) kann die Morbidität, die mit einem dorsalen Zugang verbunden ist, vermieden werden. In dieser prospektiven Studie wurden die Ergebnisse nach monosegmentaler ventraler intersomatischer Fusion (vF) mit einem PEEK-Cage mit integrierter winkelstabil verankerter Platte (SynFix-LR™) evaluiert.

Material und Methoden

Es wurden 32 Patienten mit Osteochondrose (L4/5/L5/S1) mit einer ventralen intersomatischen Fusion mittels SynFix-LR™ versorgt. Postoperativ sowie nach 3, 6, 9, 12 und 24 Monaten wurden „Oswestry Disability Index“ (ODI), visuelle Analogskala (VAS) und Fragen zur Zufriedenheit und Schmerzmitteleinnahme erfasst. Die Evaluation der Fusionsraten erfolgte mittels Röntgen und CT.

Ergebnisse

Im Verlauf kam es zur signifikanten Reduktion des ODI und der VAS bei hoher Zufriedenheit. Nach 2 Jahren konnten 79% der Patienten auf eine Dauermedikation von Analgetika verzichten und es war eine Fusionsrate von 93% (Röntgen) bzw. 79% (CT) zu verzeichnen.

Schlussfolgerungen

Der SynFix-LR™ eignet sich zur Behandlung monosegmentaler Osteochondrosen in den Segmenten L4/5 und L5/S1 bei gleichwertigen bis besseren Ergebnissen im Vergleich zu den dorsalen und ventrodorsalen Fusionsverfahren.

Abstract

Background

With anterior lumbar interbody fusion (ALIF) alone, the morbidity associated with a posterior approach can be avoided. In this study we evaluated the use of a PEEK cage with an integrated angle-stable locking plate (SynFix-LR™).

Material and methods

Thirty-two patients with osteochondrosis at L4/5 or L5/S1 were treated with the SynFix-LR™. Follow-up at 0, 3, 6, 9, 12, and 24 months included the Oswestry Disability Index (ODI), visual analog scale (VAS), and questions regarding satisfaction and use of pain medication. The fusion rate was assessed by X-ray and computed tomography (CT) examination.

Results

A significant reduction of the ODI and VAS was achieved (p<0.05) with a high rate of patient satisfaction. After 2 years, 79% of the patients were able to dispense with long-term use of analgesics. We observed a fusion rate of 93% (X-ray) and 70% (CT) at final follow-up.

Conclusion

The SynFix-LR™ device is a suitable option for the treatment of monosegmental osteochondrosis at L4/5 and L5/S1 with comparable or superior results in comparison to posterior or combined fusion techniques.

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Authors and Affiliations

  1. Centrum für Muskuloskeletale Chirurgie, Klinik für Orthopädie, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland

    E. Hoff, P. Strube, C. Groß, T. Hartwig & M. Putzier

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  1. E. Hoff
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  2. P. Strube
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  3. C. Groß
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  4. T. Hartwig
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  5. M. Putzier
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Correspondence to E. Hoff.

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Hoff, E., Strube, P., Groß, C. et al. Die monosegmentale ventrale Spondylodese mit dem SynFix-LR™. Orthopäde 39, 1044–1050 (2010). https://doi.org/10.1007/s00132-010-1654-9

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  • DOI: https://doi.org/10.1007/s00132-010-1654-9

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