Influence of lumbar intervertebral disc degeneration on the outcome of total lumbar disc replacement: a prospective clinical, histological, X-ray and MRI investigation

Biomechanics of the L5–S1 motion segment after total disc replacement – Influence of iatrogenic distraction, implant positioning and preoperative disc height on the range of motion and loading of facet joints

“…distraction, as shown in the present study. Thus, in accordance with our first hypothesis, a greater distraction substantially alters segmental kinematics and does not per se increase the overall stability of the segment in flexion-extension as well as in axial rotation and lateral bending, as previously supposed Siepe et al, 2012). In addition to these substantial alterations in segmental kinematics, a sole iatrogenic distraction can result in high FCLFs during surgery and thus might harm these ligaments during the surgical intervention.…”

“…The influence of the preoperative disc height on the outcome after of TDR is an on-going subject of debate; some authors argue that a preoperative more rigid and collapsed disc might compensate for the rotational instability of an artificial disc (e.g., Siepe et al, 2012). In the present study, FE models type 1 and 4 with higher preoperative disc heights and thus lower disc stiffnesses, predicted a larger average RoM, especially during flexion (Maquer et al, 2014).…”

Mid- to long-term results of total lumbar disc replacement: a prospective analysis with 5- to 10-year follow-up

“…Considerable progress with regard to the assessment of adequate indications and contraindications for TDR has been made [33][34][35][36][37][63][64][65][66], outcome-determining factors have been identified including the adequate extent of DDD, knowledge on the center of rotation, segmental and sagittal alignment after TDR, influence of pre-and postoperative mobility, and adequate implant placement [15,[67][68][69][70][71][72][73][74][75][76][77][78][79][80]. Similarly, biomechanical and radiological studies have investigated the effect of TDR on the index and adjacent level as well as motion characteristics of the prosthesis and the lumbar spine to a large extent .…”

Biomechanical function of a balloon nucleus pulposus replacement system: A human cadaveric spine study

“…Typical surgical methods include simple discectomy and/or spinal fusion with or without spinal instrumentation. Recent innovative motion‐sparing surgical techniques include artificial disc replacement technologies, posterior dynamic stabilization, and disc nucleus replacement (DNR) . The principles underlying these procedures are related to either ablation of IVD structures considered as “pain generators” or to stabilization of abnormal motion patterns …”