Acta Neurochirurgica

, Volume 160, Issue 8, pp 1611–1612 | Cite as

Reply to the letter to the editor of E. Shiban and B. Meyer regarding “Endplate changes after lumbar discectomy with and without implantation of an annular closure device” by Barth M et al., (Acta Neurochir (Wien) 2018 Apr;160(4):855–862)

  • Martin BarthEmail author
  • Christel Weiß
  • Gerrit J. Bouma
  • Richard Bostelmann
  • Adisa Kursumovic
  • Javier Fandino
  • Claudius Thomé
Letter to the editor - Spine - Other
Part of the following topical collections:
  1. Spine - Other

Dear Editor,

We thank the authors for their interest in our original submission [3] and the subsequent letter. We had reported on the incidence and size of end plate changes (EPC) 12 months after microdiscectomy with (n = 242) or without (n = 251) implantation of an annulus closure device (ACD). EPC increased in both groups, but were significantly more pronounced after additional ACD implantation. Presence and growth of EPC, however, was not correlated with low back pain or ODI.

The authors of the letter hypothesize causality between the presence of low virulent anaerobic bacteria and EPC, which is obviously based on a single case of ACD anchor loosening they have encountered [7]. However, current evidence clearly speaks against the authors’ speculations:

First, there was not a single case of implant loosening in our series of 242 patients that would resemble the authors’ case report [7]. EPC should not be intermingled with aseptic implant failure or loosening, as they generally occur...


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Martin Barth
    • 1
    Email author
  • Christel Weiß
    • 2
  • Gerrit J. Bouma
    • 3
  • Richard Bostelmann
    • 4
  • Adisa Kursumovic
    • 5
  • Javier Fandino
    • 6
  • Claudius Thomé
    • 7
  1. 1.Department of NeurosurgeryKlinikum Frankfurt HöchstFrankfurt am MainGermany
  2. 2.Department of Medical StatisticsUniversity Medicine Mannheim, Medical Faculty Mannheim of the University of HeidelbergHeidelbergGermany
  3. 3.Department of NeurosurgeryOLVG/Academic Medical CenterAmsterdamNetherlands
  4. 4.Department of NeurosurgeryHeinrich Heine-UniversityDuesseldorfGermany
  5. 5.Department of NeurosurgeryDONAUISAR KlinikumDeggendorfGermany
  6. 6.Department of NeurosurgeryKantonsspital AarauAarauSwitzerland
  7. 7.Department of NeurosurgeryMedical University InnsbruckInnsbruckAustria

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