Prospektive Pilotstudie an Patienten mit transpedikulärer DDS-Verschraubung bei degenerativen Wirbelsäulenerkrankungen unter besonderer Berücksichtigung der Montagerigidität

Purpose of the study: To analyze the results after transpedicular spinal fusion for degenerative disorders with adjustable rigidity of the instrumentation in a standardized manner. With increasing popularity of spinal fusion surgery consecutive instability of motion segments adjacent to fused segments has become an issue of interest. The effects of such kind of surgery should thus be evaluated to allow conclusions about the best choice for transpedicular implants. To estimate the required number of patients to verify differences in the clinical outcome between rigid and semi-rigid instrumentation. To evaluate the x-rays by using a special technique of measurement and looking for a correlation to the clinical result. 52 patients with the indication for dorsal spondylodesis were taken in this prospective cohort study. Conclusions: Semirigid instrumentation can achieve clinical and radiological results equivalent to rigid techniques.Even though no overt instability of adjacent segments could be detected on additional functional x-rays during the first three years, rigid instrumentation may promote adjacent compensatory hypermobility and consecutive degeneration over longer time which may be reduced by use of semirigid implants. The preoperative application for an early retirement should be considered as a relative contraindication. Besides technical skill and a recommendable implant, careful patient selection is the key for success.