Clinical Experience With Cespace, the New Intervertebral Disc Spacer by Aesculap for Spondylodesis of the Cervical Spine, in Comparison With Similar Products by Weber, Intromed, and AcroMed

Ventral spondylodesis by autologous bone grafting in cases of degenerative disease of the cervical spine bears the disadvantage of the complication of pain at the iliac crest. The question is if these problems can be avoided by implanting intervertebral disc spacers. Between September 1997 and December 2000, we operated on 145 patients suffering from degenerative diseases, including osteochondrosis and/or disc prolapse, of the cervical spine. Without any patient diagnosis selection, we implanted various randomly chosen disc spacer types, including 52 titanium disc spacers (Cespace) by Aesculap, 40 titanium spacers by Weber, 36 titanium spacers by Intromed, and 17 carbonium spacers by AcroMed, through anterior access and after microsurgical discectomy and removal of the dorsal osteophytes by a high-speed drill. We evaluated the handling, radiographic contrast, and costs of implantation as well as the clinical outcome after 3 months and 1 year, respectively. All four disc spacer models are suitable for the anterior spondylodesis of the cervical spine. The titanium spacer by Weber features good handling characteristics and a moderate purchase price. Cost efficiency and easy handling characterize the Intromed cage. The radiographic contrast of the carbonium spacer by AcroMed is insufficient for a controlled implantation in some cases, especially in the lower cervical spine. The handling is good, but the price is high. The AcroMed and Intromed spacers show a tendency to penetrate the base and/or cartilaginous plate of the adjacent vertebrae. Results lead us to favor the Aesculap Cespace, which impresses us by its handling and moderate price. The final assessment depends on the long-term clinical outcome for the cases studied.