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Biodegradierbarer Cage

Osteointegration bei Spondylodese der Schafhalswirbelsäule

Biodegradable cage

Osteointegration in spondylodesis of the sheep cervical spine

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Zusammenfassung

Ein biodegradierbarer Cage kann eine Vielzahl von Vorteilen gegenüber dem autologen trikortikalen Beckenkammspan und metallischen Cages bieten. Zum jetzigen Zeitpunkt steht jedoch kein solcher für die Anwendung beim Menschen zur Verfügung. Ziel dieser Studie war, 2 Fusionstechniken für die intervertebrale Spondylodese miteinander zu vergleichen. Der autologe trikortikale Beckenkammspan wurde mit einem biodegradierbaren Cage in einem tierexperimentellen Fusionsmodell für die intervertebrale Spondylodese an Schafhalswirbelsäulen von 16 ausgewachsenen Merinoschafen verglichen. Nach 12 Wochen konnte kein signifikanter Unterschied zwischen dem biodegradierbaren PLDLLA-Cage und dem trikortikalen Beckenkammspan für die intervertebrale Fusion an der Schafhalswirbelsäule gefunden werden. Jedoch zeigte der PLDLLA-Cage im gesamten Intervertebralraum Fremdkörperreaktionen von Grad I–III. Obwohl die Entstehung dieser großen Fremdkörperreaktionen derzeit noch unklar ist, kann davon ausgegangen werden, dass das bereits frühe Auftreten von großen Osteolysen und ventraler Implantatwanderung in Verbindung mit dem PLDLLA-Cage seine Anwendung beim Menschen fragwürdig erscheinen lässt.

Abstract

Bioabsorbable implants are commonplace in knee and shoulder surgery. Bioabsorbable poly(l-lactide-co-D,L-lactide) (PLDLLA) cage devices have potential benefits over autologous tricortical iliac crest bone graft and metallic cages for cervical spine interbody fusion. The purpose of this study was to compare interbody fusion of an autologous tricortical iliac crest bone graft with that of a bioabsorbable cage using a sheep cervical spine interbody fusion model. This study was designed to determine differences in (1) the ability to preserve postoperative distraction, (2) biomechanical stability, and (3) histological characteristics of intervertebral bone matrix formation. Sixteen full-grown Merino sheep underwent C3/4 discectomy and fusion. After 12 weeks, there was no significant difference between the results with the bioabsorbable PLDLLA cages and tricortical bone grafts. The cage also did not show advanced interbody fusion but did, however, show large osteolysis, which allows skepticism regarding the value of this bioabsorbable implant.

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Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.

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Authors and Affiliations

  1. Unfall- und Wiederherstellungschirurgie, Universitätsklinikum Charité, Humboldt-Universität, Campus Virchow-Klinikum, Berlin

    R. Pflugmacher, T. Eindorf, M. Scholz, S. Gumnior, C. Krall, P. Schleicher, N. P. Haas & F. Kandziora

  2. Unfall- und Wiederherstellungschirurgie, Universitätsklinikum Charité, Humboldt-Universität, Campus Virchow-Klinikum, Augustenburgerplatz 1, 13353 , Berlin

    R. Pflugmacher

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  1. R. Pflugmacher
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Correspondence to R. Pflugmacher.

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Pflugmacher, R., Eindorf, T., Scholz, M. et al. Biodegradierbarer Cage. Chirurg 75, 1003–1012 (2004). https://doi.org/10.1007/s00104-004-0884-y

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