Since total disc replacement (TDR) has broadened the spectrum of surgical treatment of degenerative spine diseases many comparison studies, particularly with interbody fusions (IF), have been done. Even though comparable results concerning functionality, radiologic results and subjective rating of life-quality have been presented, very few data about athletic activity before and after spine surgery exists.

Material and Methods: Between 1/2002 and 10/2006 181 patients had interbody fusions and 57 had a total disc replacement. Of 86 IF-patients and 25 patients with TDR we have complete data, which was collected in pre- and postoperative clinic and radiologic routine control with standardised questionnaires containing evaluation of level (frequency) and sort of sport. Patients are matched according to demographic data and preoperative activity beside the most important match of operation method.

Results: Patients with Total disc replacement show a later resumption of sports (19 weeks) than fusion patients (14 weeks), but more TDR patients (60%) achieve their preoperative level of sport than IF-patients (36%) do. Vice versa to the Fusion group in the TDR group more patients start a new sport after surgery than to stop one. Percentage of patients doing sports post- compared to preoperative is higher in both groups. Less patients having a TDR complain about technical limitations during practicing sports than fusion patients.

Discussion: Despite later resumption of athletic activity TDR seems to be the better surgical treatment of degenerative disc diseases in active patients and athletes due to overall higher sports levels. If long term results can keep up with short time follow ups has to be questioned.

Kyphoplasty is an efficient tool in the treatment of primary tumours (plasmocytoma) and osteolytic metastasis. Especially in plasmocytoma the current chemotherapy has increased life expectancy significantly. Therefore minimal-invasive stabilisation is not only a palliative treatment but really increases quality of life in those cases.

Kyphoplasty offers several special tools and techniques to lower the leakage rate which is especially high with other cementoplasty techniques in the osteolytic spine.

Materials and Methods: Prospective study of all vertebral tumours compared to osteoporotic fractures treated with kyphoplasty in 2004. 6 months follow up with VAS, SF36 and Oswestry score.

Results: In 2004 we performed 67 Kyphoplasties. 12 kyphoplasties were performed in tumour cases (5 plasmocytoma and 7 metastasis). No complications occurred during surgery and during hospital stay. Follow-up included 11 tumours (1 death during F/U) and 46 osteoporotic fractures. 1 patient was treated with combined decompression/kyphoplasty. The pain level (VAS) was significantly reduced in all cases within 2 days (osteoporotic group 2,2 – tumour group 5,4) and reached nearly the same result after 6 weeks which persisted for 6 months (osteoporotic group 1,6, tumour group 2,1). The SF 36/Oswestry Score improved accordingly in both groups. At 6 weeks and 6 months F/U no statistical difference in the scores was seen.

Conclusion: Kyphoplasty is a safe treatment method for osteolytic vertebral tumours with vertebral collapse. Clinically the results don’t differ from conventional cases. In cases with canal compromise, a combination with open techniques is possible. Special kyphoplasty techniques allow a reconstruction of the lytic wall and minimise leakage and cement dislocation. Significant improvement of life quality can be achieved offering the spine surgeon a valuable tool in the treatment of spinal metastasis.