Experimental Design of Total Disk Replacement—Experience with a Prospective Randomized Study of the SB Charitè

McAfee, Paul C.; Fedder, Ira L.; Saiedy, Samer; Shucosky, Erin M.; Cunningham, Bryan W.

doi:10.1097/01.brs.0000092217.34981.e1

Cited by 55 publications

(27 citation statements)

References 20 publications

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“…The device configuration is mostly a total replacement design from anterior transabdominal or retroperitoneal approach [6,8,11,14,23,37]. The representative metal on polymer artificial discs include SB Charite and ProDisc, in which polyethylene core is placed between two metal endplates with unconstrained or semi-constrained design and in macrophages at periprosthetic tissues with Bryan cervical disc replacement [1].…”

Section: Discussionmentioning

confidence: 99%

“…Recent artificial disc prostheses are classified into a metal on polymer [4,11,13,14,23,37], metal on metal [7,15,19], and exclusive polymer design [18,20,21,29,30,35,36]. The device configuration is mostly a total replacement design from anterior transabdominal or retroperitoneal approach [6,8,11,14,23,37].…”

Section: Discussionmentioning

confidence: 99%

“…Recent artificial intervertebral disc technology serves as the next frontier in the surgical management of intervertebral disc pathology [2,3,5,6,8,11,[14][15][16][17][18][19][20][21][22][23]29,30,33,37]. As an alternative to arthrodesis, an artificial disc serves to replace the symptomatic disc, and restores the functional mobility and disc height of the motion segment.…”

Section: Introductionmentioning

confidence: 99%

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Multidirectional flexibility analysis of anterior and posterior lumbar artificial disc reconstruction: in vitro human cadaveric spine model

et al. 2006

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The in vitro multidirectional flexibility analysis was conducted to investigate the initial biomechanical effect of biomimetic artificial intervertebral disc replacement from either anterior or posterior approach in a cadaveric lumbosacral spine model. Two designs of anterior total and posterior subtotal artificial discs were developed using bioactive three-dimensional fabric and bioresorbable hydroxyapatite/poly-l-lactide (HA/PLLA) material (3DF disc). Both models were designed to obtain the stable interface bonding to vertebral endplates with maximum surface area occupation. Using seven cadaveric lumbosacral spines, the following three anterior reconstruction methods were sequentially performed at L4-5 level: anterior 3DF disc replacement; anterior BAK cages (BAK); and posterior pedicle screw fixation and anterior BAK cages combined (BAK+ PS).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Multidirectional flexibility analysis of anterior and posterior lumbar artificial disc reconstruction: in vitro human cadaveric spine model

et al. 2006

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“…The device was implanted into the discectomied space according to the manufacturer's specifications with fluoroscopy (15,16). The optimal position in the anteroposterior plane was at the midline, but it was 2 mm posterior to the midline on the lateral image.…”

Section: Fixation and Implantation In The Cadaveric Spinementioning

confidence: 99%

Biomechanical changes in disc pressure and facet strain after lumbar spinal arthroplasty with charité™ in the human cadaveric spine under physiologic compressive follower preload

Choi¹,

Kim²,

Lim³

et al. 2016

Turkish Neurosurgery

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and yet resist large compressive loads. As far as the load path remains within the limited range of the estimated rotation centers of the lumbar segments, the load-carrying capacity of the lumbar spine increases under a compressive follower load (19).We previously published a biomechanical study on the range of motion (ROM) changes following lumbar spinal arthroplasty █ InTRODuCTIOn T he lumbar arthroplasty technique was developed to maintain the biomechanical features of a healthy disc, to decrease the rate of adjacent segment disease, and to lower the rate of accelerated degeneration of the neighboring discs that occurs in traditional fusion procedures. The follower load path explains how the whole lumbar spine can be lordotic AIM: Arthroplasty maintains the biomechanical features of a healthy disc, decreases the adjacent segment disease rate, and decreases the accelerated degeneration rate of the neighboring discs in traditional fusion procedures. However, there are only a few reports on adjacent disc pressure (DP) and facet strain (FS) after lumbar arthroplasty under a physiologic compressive preload. MATERIAL and METhODS:Baseline DP and FS measurements were obtained from five intact cadaveric human lumbosacral spines for different modes of motion. DP was measured by inserting pressure transducer needle tips into the L3-L4 and L5-S1 discs. FS gauges were fixed on both sides of the laminae near the L3-L4, L4-L5, and L5-S1 facet joints. After SB Charité™ III implantation at the L4-L5 level, the measurements were repeated at preload and compared with those of the intact spine. RESuLTS:Under the preload condition, the central DP of the upper disc was decreased during extension and bending, and it significantly increased during rotation (p < 0.05). In the lower disc, the central DP insignificantly decreased during bending and increased during extension and flexion. A statistically significant increase in FS was observed during rotation at the operative facet (p < 0.05). Compared to the intact spine, all FS values were insignificantly decreased during lateral bending but increased during axial rotation. COnCLuSIOn:In an ex-vivo physiologic preload setting, the SB Charité™ III provided relatively inconsistent and sometimes increased DP or FS at the operative and adjacent levels after arthroplasty.

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“…The device was implanted in the discectomy defect per manufacturer's specifications, and according to the previously reported surgical technique 30,32) . The midline of the spinal column was marked by placing a screw in the vertebral body above the index disc.…”

Section: Discectomy and Artificial Disc Implantationmentioning

confidence: 99%

The Changes in Range of Motion after a Lumbar Spinal Arthroplasty with Charité™ in the Human Cadaveric Spine under Physiologic Compressive Follower Preload : A Comparative Study between Load Control Protocol and Hybrid Protocol

Kim

Chang

et al. 2009

J Korean Neurosurg Soc

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Objective: To compare two testing protocols for evaluating range of motion (ROM) changes in the preloaded cadaveric spines implanted with a mobile core type Charité ™ lumbar artificial disc. Methods: Using five human cadaveric lumbosacral spines (L2-S2), baseline ROMs were measured with a bending moment of 8 Nm for all motion modes (flexion/extension, lateral bending, and axial rotation) in intact spine. The ROM was tracked using a video-based motion-capturing system. After the Charité ™ disc was implanted at the L4-L5 level, the measurement was repeated using two different methods : 1) loading up to 8 Nm with the compressive follower preload as in testing the intact spine (Load control protocol), 2) loading in displacement control until the total ROM of L2-S2 matches that when the intact spine was loaded under load control (Hybrid protocol). The comparison between the data of each protocol was performed. Results: The ROMs of the L4-L5 arthroplasty level were increased in all test modalities (p < 0.05 in bending and rotation) under both load and hybrid protocols. At the adjacent segments, the ROMs were increased in all modes except flexion under load control protocol. Under hybrid protocol, the adjacent segments demonstrated decreased ROMs in all modalities except extension at the inferior segment. Statistical significance between load and hybrid protocols was observed during bending and rotation at the operative and adjacent levels (p < 0.05). Conclusion: In hybrid protocol, the Charité ™ disc provided a relatively better restoration of ROM, than in the load control protocol, reproducing clinical observations in terms of motion following surgery.

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Experimental Design of Total Disk Replacement—Experience with a Prospective Randomized Study of the SB Charitè

Abstract: This is the first study that shows improvement of functional outcome measures in a prospective randomized design treating primarily mechanical back pain and achieving comparable successful results to lumbar spinal stenosis decompression.

Cited by 55 publications

References 20 publications

Multidirectional flexibility analysis of anterior and posterior lumbar artificial disc reconstruction: in vitro human cadaveric spine model

Multidirectional flexibility analysis of anterior and posterior lumbar artificial disc reconstruction: in vitro human cadaveric spine model

Biomechanical changes in disc pressure and facet strain after lumbar spinal arthroplasty with charité™ in the human cadaveric spine under physiologic compressive follower preload

The Changes in Range of Motion after a Lumbar Spinal Arthroplasty with Charité™ in the Human Cadaveric Spine under Physiologic Compressive Follower Preload : A Comparative Study between Load Control Protocol and Hybrid Protocol

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Experimental Design of Total Disk Replacement—Experience with a Prospective Randomized Study of the SB Charitè

Abstract: This is the first study that shows improvement of functional outcome measures in a prospective randomized design treating primarily mechanical back pain and achieving comparable successful results to lumbar spinal stenosis decompression.

Cited by 55 publications

References 20 publications

Multidirectional flexibility analysis of anterior and posterior lumbar artificial disc reconstruction: in vitro human cadaveric spine model

Multidirectional flexibility analysis of anterior and posterior lumbar artificial disc reconstruction: in vitro human cadaveric spine model

Biomechanical changes in disc pressure and facet strain after lumbar spinal arthroplasty with charité&#8482; in the human cadaveric spine under physiologic compressive follower preload

The Changes in Range of Motion after a Lumbar Spinal Arthroplasty with Charité™ in the Human Cadaveric Spine under Physiologic Compressive Follower Preload : A Comparative Study between Load Control Protocol and Hybrid Protocol

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Biomechanical changes in disc pressure and facet strain after lumbar spinal arthroplasty with charité™ in the human cadaveric spine under physiologic compressive follower preload