Comparison of spinal surgery with different types of implant

There are several treatment options available for patients with therapy-resistant pain or degenerative changes to the cervical and lumbar spine. One potential intervention is the fusion—and stabilisation—of the affected vertebral bodies with a metal rod. An alternative treatment is the implantation of a flexible disc prosthesis. This report explores the efficacy and safety of the various procedures in different patient groups.

The studies reviewed in the report compare the different interventions, showing no detectable difference between some measures and slight differences between others. For instance, compared with the direct fusing of vertebral bodies with metal rods, there is evidence that implanting disc prostheses for lumbar vertebrae reduces back pain and increases both the patient’s quality of life and flexibility. A similar picture emerges from the comparison of direct stabilisation and implantation of prostheses for neck vertebrae. Prosthetic implants led to fewer instances of back and neck pain, improved the patients’ quality of life, mental health, and flexibility.

The report concludes that, based on the available data, no clear picture emerges as to the comparative efficacy of the different procedures, even though some appear to yield better results than others. The quality of the studies reviewed is judged to be very low due to the presence of inconsistencies, imprecisions and risk of bias among the people involved in the procedures. Overall, the results are inconclusive.

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