Acta Neurochirurgica

, Volume 121, Issue 3–4, pp 191–195 | Cite as

Anterior cervical discectomy and vertebral interbody fusion with hydroxy-apatite ceramic. Preliminary results

  • D. K. Böker
  • R. Schultheiß
  • D. van Roost
  • J. F. Osborn
  • B. Kaden
Technical Notes


Intervertebral plates of hydroxy apatite ceramic (HAC) have been used in three patients for cervical vertebral interbody fusion after anterior discectomy. In one case a pure HAC “Disc” was used, which proved to be too friable. Specially designed intervertebral plates, which were composed of an HAC-coated core of alumina ceramic, were used in the other two cases. Clinically and radiologically optimal results after 1-year- and 2-year-follow-up suggest that HAC-ceramic might be a very promising material for vertebral interbody fusion. Possible complications and pain due to bone removal from the iliac crest are avoided, and the operative procedure is simplified.


Cervical discectomy vertebral interbody fusion hydroxy apatite ceramic 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Alemo-Haddad S (1985) Use of acrylic in anterior cervical discectomy: technical note. Neurosurgery 17: 94–96PubMedGoogle Scholar
  2. 2.
    Barber A (1978) Anterior cervical fusion. The postoperative complications. Rocky Mt Med J 75: 29–33PubMedGoogle Scholar
  3. 3.
    Bertalanffy H, Eggert HR (1988) Clinical long-term results of anterior discectomy without fusion for treatment of cervical radiculopathy and myelopathy. A follow-up of 164 cases. Acta Neurochir (Wien) 90: 127–135Google Scholar
  4. 4.
    Böker DK, Schultheiß R, Probst EM (1989) Radiologic longterm results after cervical vertebral interbody fusion with polymethylmethacrylate (PMMA). Neurosurg Rev 12: 217–221PubMedGoogle Scholar
  5. 5.
    Cloward RB (1958) The anterior approach for removal of ruptured cervical discs. J Neurosurg 15: 602–617PubMedGoogle Scholar
  6. 6.
    Distelmaier P, Vlajic I, Wappenschmidt J (1979) Necrosis of vertebrae after Cloward's operation of the cervical spine using “Palacos” for fixation. Adv Neurosurg 7: 160–163Google Scholar
  7. 7.
    Donath K (1988) Der Einbau von Knochenersatzmaterialien im Kieferknochen. Morphologische Befunde. Dtsch Zahnaerztl Z 43: 16–21PubMedGoogle Scholar
  8. 8.
    Gersdorff M, Vilain J (1989) Les reconstructions osseuses dans la microchirurgie de'l oreille moyenne. Acta Otorhinolaryngol Belg 43: 481–488PubMedGoogle Scholar
  9. 9.
    Grau H, Hardt N (1988) Kieferkammaufbau. Augmentative Kieferkammplastik mit Hydroxylapatit. Schweiz Monatsschr Zahnmed 89: 273–278Google Scholar
  10. 10.
    Green PWB (1977) Anterior cervical fusion: a review of thirtythree patients with cervical disc degeneration. J Bone Joint Surg (Br) 59B: 236–240Google Scholar
  11. 11.
    Grote W, Bettag W, Wüllenweber R (1970) Indikation, Technik und Ergebnisse cervicaler Fusionen. Acta Neurochir (Wien) 22: 1–27Google Scholar
  12. 12.
    Heise U, Osborn JF, Duwe F (1990) Hydroxyapatite ceramic as a bone substitute. Int Orthop 14: 329–338PubMedGoogle Scholar
  13. 13.
    Hirsch C, Wickbom I, Lidström A, Rosengren K (1964) Cervical disc resection. A follow-up of myelographic and surgical procedure. J Bone Joint Surg 46A: 1811–1821Google Scholar
  14. 14.
    Hirsch RS, Smith K, Vernon-Roberts B (1985) A morphological study of macrophage and synovial cell interactions with hydroxyapatite crystals. Ann Rheum Dis 44: 844–851PubMedGoogle Scholar
  15. 15.
    Kent JN, Finger IM, Quinn JH (1986) Hydroxylapatite alveolar ridge reconstruction. J Oral Maxillofac Surg 44: 37–49PubMedGoogle Scholar
  16. 16.
    Koyama T, Handa J (1985) Cervical laminoplasty using apatite beads as implants. Surg Neurol 24: 663–667PubMedGoogle Scholar
  17. 17.
    Krueger E, Ghavami C (1988) Technik und Ergebnisse der aufbauenden Alveolarkammplastik mit Hydroxylapatitkeramik im vorgeformten Transplantatbett. Dtsch Zahnaerztl Z 43: 127–128PubMedGoogle Scholar
  18. 18.
    Lozes G, Fawaz A, Cama A, Krivosic I, Devos P, Herlant M, Serti GO, Clarisse J, Jomin M (1989) Discectomies of the lower cervical spine using interbody biopolymer (B.O.P.) implants. Acta Neurochir (Wien) 96: 88–93Google Scholar
  19. 19.
    Matukats VJ (1988) Hydroxylapatite: an adjunct to cranial bone grafting. J Neurosurg 69: 514–517PubMedGoogle Scholar
  20. 20.
    Osborn JF, Newesly H (1980) The material science of calcium phosphate ceramics. Biomaterials 1: 108–111PubMedGoogle Scholar
  21. 21.
    Osborn JF, Newesly H (1982) Bonding osteogenesis induced by calcium phosphate ceramic implants. In: Winter GD, Gibbons DF, Plenk H (eds) Biomaterials 1980. Wiley, New York, pp 51–58Google Scholar
  22. 22.
    Osborn JF, Böker DK, Schultheiß R (1986) Indikation und Technik der Rekonstruktion frontaler und fazialer Knochendefekte durch Festkörperimplantate aus Hydroxylapatitkeramik. In: Neubauer N (ed) Plastische und Wiederherstellungschirurgie des Alters. Springer, Berlin Heidelberg New York Tokyo, pp 196–202Google Scholar
  23. 23.
    Roosen K, Grote W, Bettag W (1975) Komplikationen zervikaler ventraler Fusionsoperationen. Neurochirurgia (Stuttg) 18: 1–11Google Scholar
  24. 24.
    Schultheiß R, Böker DK, Osborn JF (1987) Rekonstruktion frontaler und fazialer Knochendefekte durch poröse Hydroxylapatitkeramik. In: Kastenbauer E, Wilmes E, Mees K (eds) Das Transplantat in der plastischen Chirurgie. Springer, Berlin Heidelberg New York Tokyo, pp 367–371Google Scholar
  25. 25.
    Smith GW, Robinson RA (1958) The treatment of certain cervical spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg 40A: 607–624Google Scholar
  26. 26.
    Yamashita T (1989) Cranioplasty with hydroxylapatite ceramic plates that can easily be trimmed during surgery. Acta Neurochir (Wien) 96: 149–153Google Scholar

Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • D. K. Böker
    • 1
  • R. Schultheiß
    • 1
  • D. van Roost
    • 1
  • J. F. Osborn
    • 2
  • B. Kaden
    • 1
  1. 1.Department of NeurosurgeryUniversity of BonnBonnFederal Republic of Germany
  2. 2.Department of Oro-Maxillo-Facial SurgeryUniversity of BonnBonnFederal Republic of Germany

Personalised recommendations