Intervertebral Disc Prosthesis: Results and Prospects for the Year 2000

Lemaire, J. P.; Skalli, Wafa; Lavaste, F.; Templier, Alexandre; Mendes, Felipe Campos; Diop, Amadou Gallo; Sauty, V; Laloux, E.

doi:10.1097/00003086-199704000-00009

Cited by 257 publications

(138 citation statements)

References 27 publications

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“…The results for the Charité in the current study are in line with the findings of Lemaire et al [17], as they also report about a significant increase of flexion/extension and axial rotation, but a non-significant increase for lateral bending after in vitro evaluation of the Charité. Similar results were observed in two other finite-element model studies for the Charité and Prodisc.…”

Section: Discussionsupporting

confidence: 93%

The role of prosthesis design on segmental biomechanics

et al. 2010

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The purpose of this study was to evaluate the influence of different implant designs of total lumbar disc replacements on the segmental biomechanics of the lumbar spine. The unconstrained Charité, the semi-constrained Prodisc and a semi-constrained Prototype with more posterior centre of rotation than the Prodisc were tested in vitro using six human, lumbar spines L2-L5. The segmental lordosis was measured on plain radiographs and the range of motion (ROM) for all six degrees of freedom with a previously described spine tester. All prostheses were implanted at level L3-

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Section: Discussionsupporting

confidence: 93%

The role of prosthesis design on segmental biomechanics

et al. 2010

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“…Reported problems associated with TDR include excessive ligament torsions, increased facet pressures, a high risk of instability at the index and adjacent level, up to 2.59 increased load on posterior structures and altered load patterns with sudden rather than gradual load increase in the facet joints [17,39]. Furthermore, it has been shown that TDR with Charité III did not restore the physiological segmental rotational stability with additive destabilising effects for multilevel versus monosegmental TDRs [13,47].…”

Section: Biomechanical Studiesmentioning

confidence: 99%

Analysis of post-operative pain patterns following total lumbar disc replacement: results from fluoroscopically guided spine infiltrations

Siepe¹,

Korge²,

Grochulla³

et al. 2007

Eur Spine J

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Although a variety of biomechanical laboratory investigations and radiological studies have highlighted the potential problems associated with total lumbar disc replacement (TDR), no previous study has performed a systematic clinical failure analysis. The aim of this study was to identify the post-operative pain sources, establish the incidence of post-operative pain patterns and investigate the effect on post-operative outcome with the help of fluoroscopically guided spine infiltrations in patients from an ongoing prospective study with ProDisc II. Patients who reported unsatisfactory results at any of the FU-examinations received fluoroscopically guided spine infiltrations as part of a semi-invasive diagnostic and conservative treatment program. Pain sources were identified in patients with reproducible (C29) significant (50-75%) or highly significant (75-100%) pain relief. Results were correlated with outcome parameters visual analogue scale (VAS), Oswestry disability index (ODI) and the subjective patient satisfaction rate. From a total of 175 operated patients with a mean follow-up (FU) of 29.3 months (range 12.2-74.9 months), n = 342 infiltrations were performed in n = 58 patients (33.1%) overall. Facet joint pain, predominantly at the index level (86.4%), was identified in n = 22 patients (12.6%). The sacroiliac joint was a similarly frequent cause of post-operative pain (n = 21, 12.0%). Pain from both structures influenced all outcome parameters negatively (P \ 0.05). Patients with an early onset of pain (B6 months) were 2-59 higher at risk of developing persisting complaints and unsatisfactory outcome at later FU-stages in comparison to the entire study cohort (P \ 0.05). The level of TDR significantly influenced postoperative outcome. Best results were achieved for the TDRs above the lumbosacral junction at L4/5 (incidence of posterior joint pain 14.8%). Inferior outcome and a significantly higher incidence of posterior joint pain were observed for TDR at L5/S1 (21.6%) and bisegmental TDR at L4/5/S1 (33.3%), respectively. Lumbar facet and/or ISJpain are a frequent and currently underestimated source of post-operative pain and the most common reasons for unsatisfactory results following TDR. Further failureanalysis studies are required and adequate salvage treatment options need to be established with respect to the underlying pathology of post-operative pain. The question as to whether or not TDR will reduce the incidence of posterior joint pain, which has been previously attributed to lumbar fusion procedures, remains unanswered. Additional studies will have to investigate whether TDR compromises the index-segment in an attempt to avoid adjacent segment degeneration.

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“…In the short term, these devices have been as successful in terms of pain relief and patient satisfaction as spinal fusion [1][2][3][4]. Revision rates of lumbar TDR, at 6-11.2% [5,6], are also comparable to fusion, at 5.8-22% [6,7] within 2 years.…”

Section: Introductionmentioning

confidence: 99%

The effect of anterior–posterior shear load on the wear of ProDisc-L TDR

et al. 2010

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The current wear-testing standard (ISO18192-1) for total disc replacement (TDR) requires only four degrees of freedom (DOF) inputs: axial load, flexionextension, lateral bending and axial rotation. The study aim was to assess the effect of an additional DOF, anterior-posterior (AP) shear on the wear of the ProDisc-L TDR. A 5DOF simulator was used to test ProDisc-L implants under 4DOF and 5DOF conditions. The 4DOF conditions were defined by ISO18192-1 whilst the 5DOF used ISO18192-1 conditions with the addition of an AP load of ?175 and -140 N (anterior and posterior, respectively), extrapolated from in vivo data. The implants were mounted such that the polyethylene insert could be removed for gravimetric measurements. Tests were run using bovine serum (15 g/l protein concentration) as a lubricant for five million cycles (MC), with measurements repeated every 1 MC. The mean wear rate in the 4DOF test was 12.7 ± 2.1 mg/MC compared to 11.6 ± 1.2 mg/MC in the 5DOF test. There were marked differences in the wear scars between 4DOF and 5DOF simulations. With 4DOF, wear scars were centralised on the dome of the insert, whilst 5DOF scars were larger, breaching the anterior rim of the dome causing deformation at the edge. The 4DOF wear test showed similar gravimetric wear rates to previously published ISO-tested TDRs. The addition of AP load was found to have no significant effect on the overall wear rate. However, there were pronounced differences in the respective wear scars, which highlights the need for more research in order to understand the factors that influence wear of TDR.

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Intervertebral Disc Prosthesis: Results and Prospects for the Year 2000

Cited by 257 publications

References 27 publications

The role of prosthesis design on segmental biomechanics

The role of prosthesis design on segmental biomechanics

Analysis of post-operative pain patterns following total lumbar disc replacement: results from fluoroscopically guided spine infiltrations

The effect of anterior–posterior shear load on the wear of ProDisc-L TDR

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