Prosthetic Disc Nucleus Implants: The Wiesbaden Feasibility Study

Schönmayr, R.; Busch, Constant A.; Lotz, Christian; Lotz-Metz, G.

doi:10.1177/19714009990120s123

Cited by 17 publications

(11 citation statements)

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“…Several artificial nucleus implants have been developed and some of them have already been clinically applied but the success was not optimal yet [2,6,10,13,19,21,24].…”

Section: Introductionmentioning

confidence: 99%

Is a collagen scaffold for a tissue engineered nucleus replacement capable of restoring disc height and stability in an animal model?

et al. 2006

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The idea of a tissue engineered nucleus implant is to seed cells in a three-dimensional collagen matrix. This matrix may serve as a scaffold for a tissue engineered nucleus implant. The aim of this study was to investigate whether implantation of the collagen matrix into a spinal segment after nucleotomy is able to restore disc height and flexibility. The implant basically consists of condensed collagen type-I matrix. For clinical use, this matrix will be used for reinforcing and supporting the culturing of nucleus cells. In experiments, matrixes were concentrated with barium sulfate for X-ray purposes and cell seeding was disclaimed in order to evaluate the biomechanical performance of the collagen material. Six bovine lumbar functional spinal units, aging between 5 and 6 months, were used for the biomechanical in-vitro test. In each specimen, an oblique incision was performed, the nucleus was removed and replaced by a collagen-type-I matrix. Specimens were mounted in a custom-built spine tester, and subsequently exposed to pure moments of 7.5 Nm to move within the three anatomical planes. Each tested stage (intact, nucleotomy and implanted) was evaluated for range of motion, neutral zone and change in disc height. Removal of the nucleus significantly reduced disc height by 0.84 mm in respect to the intact stage and caused an instability in the segment. Through the implantation of the tissue engineered nucleus it was possible to restore this height and stability loss, and even to increase slightly the disc height of 0.07 mm compared with the intact stage. There was no statistical difference between the stability provided by the implant and intact stage. Results of movements in lateral bending and axial rotation showed the same trend compared to flexion/extension. However, implant extrusions have been observed in three of six cases during the flexibility assessment. The results of this study directly reflect the efficacy of vital nucleus replacement to restore disc height and to provide stability to intervertebral discs. However, from a biomechanical point of view, the challenge is to employ an appropriate annulus fibrosus sealing method, which is capable to keep the nucleus implant in place over a long-time period. Securing the nucleus implant inside the disc is one of the most important biomechanical prerequisites if such a tissue engineered implant shall have a chance for clinical application.

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“…Several artificial nucleus implants have been developed and some of them have already been clinically applied but the success was not optimal yet [2,6,10,13,19,21,24].…”

Section: Introductionmentioning

confidence: 99%

Is a collagen scaffold for a tissue engineered nucleus replacement capable of restoring disc height and stability in an animal model?

et al. 2006

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“…Although there have been extrusions of the PDN device after implantation through a posterior surgical approach, the initial results of the anterior implantation technique seem to be acceptable [1,30,31,34]. There are still only few data on the long-term effects and behaviour of the implants in the intervertebral disc space.…”

Section: Facts and Questionsmentioning

confidence: 99%

Non-fusion technology in degenerative lumbar spinal disorders: facts, questions, challenges

Mayer

Korge

2004

Arthroplasty of the Spine

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“…1 upper left). 43,45 To minimize the preimplantation size of the Prosthetic Disc Nucleus, the hydrogel core is compressed and dehydrated during manufacturing. Platinum-iridium wire markers inserted into the core allow radiographic identification of the device.…”

Section: Nucleus Replacementmentioning

confidence: 99%

“…This device has been extensively assessed by mechanical and in vitro testing, and the results have been favorable. 43,45 Wilke, et al, 54 examined the biomechanics of cadaveric lumbar spines in which the Prosthetic Disc Nucleus was inserted at the L4-5 level. Six spine specimens were preloaded with 200 N, after which sagittal, coronal, and axial rotation was assessed following exposure to a 7.5-Nm load in each of the respective planes.…”

Section: Nucleus Replacementmentioning

confidence: 99%

See 1 more Smart Citation

Spinal arthroplasty

Traynelis¹

2002

FOC

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Symptomatic degenerative spinal disease is a serious medical condition that affects many individuals. Modern neuroimaging modalities, the development of new medications, and advances in operative and nonoperative treatments have all contributed to improved outcomes. Unfortunately, there remain a significant number of patients in whom primary therapy either fails or new or recurrent symptoms develop over time. The last decade has witnessed the invention of devices designed to reconstruct the spinal motion segment. These devices can be divided into those that primarily function to replace a nucleus pulposus and those that completely replace the disc complex. In this article the author reviews the background leading to the development of the current group of disc replacements. The design and preliminary clinical results obtained using major lumbar and cervical devices are also reviewed.

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Prosthetic Disc Nucleus Implants: The Wiesbaden Feasibility Study

Cited by 17 publications

References 0 publications

Is a collagen scaffold for a tissue engineered nucleus replacement capable of restoring disc height and stability in an animal model?

Is a collagen scaffold for a tissue engineered nucleus replacement capable of restoring disc height and stability in an animal model?

Non-fusion technology in degenerative lumbar spinal disorders: facts, questions, challenges

Spinal arthroplasty

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