Current Situation of Design Criteria for Intervertebral Disc Prosthesis

Abstract

This paper presents the literature review on the design criteria for intervertebral disc prosthesis. The design criteria relate to the design features that intervertebral prosthesis must accomplish (i.e. fixation to bones, spine mobility, energy absorption and etcetera). The need to improve the performance has led to changes in the features which reflect in the current design criteria. Currently, the disc prosthesis technology is experiencing a generational change. The first generation was thoroughly studied while the second generation is in the clinical tests stage. During the time the first generation prostheses were applied in patients there was not a clear trend in the clinical results which produced a lack of trust and reliability in the performance of the disc prosthesis. The changes in the design features of one generation compared to the next generation are based in the deepening in the knowledge of the problem and the results obtained with the first generation prostheses. Some design criteria were identified for the first generation. These criteria were not completely characterized since there was not enough information to be used by the designer. This lack of characterization of most design criteria produced many different versions without a clear focus which help to define the basic design features of disc prostheses. This document presents the necessary information to thoroughly characterize the design criteria outlining the missing information for the design criteria found. An analysis is done of the design criteria in the second generation of prosthesis. Finally if the information contained in the design criteria is enough, the clinical results would be better focused to achieve a more repeatable, reproducible and reliable process for a total disc intervertebral prosthesis replacement as now is considered the vertebral fusion, this is a gold standard.