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Interkorporelle Metallimplantate („Cages“) bei lumbalen Spondylodesen

Interbody metal implants (“cages”) for lumbar fusion

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Zusammenfassung

Interkorporelle Metallimplantate haben im Rahmen von lumbalen Spondylodesen in den letzten 15 Jahren weltweite Verbreitung gefunden. Die sog. „Cages“ bestehen aus metallischen oder resorbierbaren Materialien und können mit Hilfe verschiedener Operationstechniken offen oder endoskopisch eingesetzt werden.

Die publizierten Ergebnisse der cagegestützten Operationsverfahren an der Lendenwirbelsäule zeigen sowohl mit als auch ohne zusätzliche Instrumentierung überwiegend hohe knöcherne Fusionsraten von >90%, wobei die zusätzliche Applikation osteoinduktiver Substanzen (v. a. BMP) noch zu einer weiteren Verbesserung zu führen scheint.

Da die dorsoventrale Spondylodese mit Fixateur interne und Knochen gleich hohe Konsolidierungsraten aufweist, sind die Vorzüge der Cages in erster Linie in der Aufrechterhaltung des Distraktionseffekts, in der Möglichkeit eines einseitigen Vorgehens ohne zusätzliche Instrumentation (auch endoskopisch) und in der geringeren „donor-side morbidity“ im Bereich der Knochenentnahmestelle zu sehen.

Abstract

Over the last 15 years, interbody metal implants have become commonly used worldwide for lumbar interbody fusion. The so called “cages” are made of metal or absorbable materials. By using different surgical techniques, they can be implanted either regularly or via endoscopy.

The published results on surgical techniques using cages for the lumbar spine show, in most cases and with or without additional instrumentation, rates of fusion of more than 90%. It seems that the use of osteoinductive substances (especially BMP) leads to even better results.

Dorsoventral fusion with internal fixation and bone show the same rate of consolidation, but the advantages of cages are primarily in the maintenance of the distraction and the possibility of a single surgical procedure without additional instrumentation (including endoscopy), and in a lower donor side morbidity.

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  1. Orthopädische Universitätsklinik Leipzig

    G. Freiherr von Salis-Soglio, R. Scholz & K. Seller

  2. Orthopädische Klinik und Poliklinik am Universitätsklinikum Leipzig AöR, Semmelweisstraße 10, 04103, Leipzig

    G. Freiherr von Salis-Soglio

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Freiherr von Salis-Soglio, G., Scholz, R. & Seller, K. Interkorporelle Metallimplantate („Cages“) bei lumbalen Spondylodesen. Orthopäde 34, 1033–1039 (2005). https://doi.org/10.1007/s00132-005-0840-7

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