ABSTRACT

Titanium cage in combination with autologous bone can be used successfully for the different types of interbody spondylodesis additionally to the other known implants. Owing to the holes located in the corpus of titanium cage there is contact between autologous bone and osseous tissue of the adjacent vertebrae. The favorable conditions have been created for formation of bone-metallic spondylodesis. During the period from 2008 to 2010 the operations with use of titanium implants for posterior interbody spondylodesis in combination with autologous bone graft were performed in 32 patients with diagnosis of lumbar osteochondrosis. Among themthere were 13 (40.6%)males, and 19 (59.4 %) females. The age of patients fluctuated from 18 till 61 years (average age 39,5 years). In the preoperative period there were performed common clinical, neurological, roentgenological, MRI, CT and MSCT investigations. For evaluation of the impaired functional ability the Oswestry Disability Index (ODI) and visual analog scale (VAS) scores were measured preand postoperatively. Roentgenographic parameters included posterior and anterior segments of interbody intervals before and after operation, as well as flexion-extension difference of the segmentary angle at a level of surgical intervention. The change of the segmentary angle value at the position of flexion and extension by less than 5˚ was evaluated as confirmation of the stable spine segment and formation of interbody block. Before operation all the patients were measured horizontal mobility 8.1±1.3 mm, and segmentary angle was more than 5˚.

Avarege preoperative VAS and ODI scores were 4.8 ± 0.5 and 68.27 ± 7.59 were impaired postopertively. In the last control visit (18-24 months), avarege VAS and ODI scores were 0.8 ± 0.4 and 12.72 ± 4.49 respectively. Postopertive average segmentary angle at the level of intervention was not higher than 5˚ and was on the average 2.3±0.3˚. The long-term postoperative results were studied in 18 patients. The results obtained were assessed as good in 25 patients, and satisfactory results in 7 patients. One patient had unsatisfactory result.

In the light of the results of the this study, the application of titanium cage has reduced traumatic effect of operation and has not required additional use of autologous bone tissue from the iliac crest were concluded.