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Total Disc Arthroplasty

Sakkadech Limmahakhun, Hayden N Box, Paul Arauz, David W Hennessy, Christian Klemt, Young-Min Kwon
Anterior instability after total hip arthroplasty (THA) has been described in patients with thoracolumbar kyphotic deformity. Although compensatory posterior pelvic tilt with subsequent increased functional anteversion has been described as the mechanism, there is a paucity of in-vivo data. The purpose of our study was to compare pelvic tilt, anteversion, inclination, and position of head-cup contact points in patients with lumbar degenerative disc disease (DDD) and a matched patient cohort without DDD. A total of 50 THA, 18 hips with lumbar DDD and 32 hips without DDD, underwent CT imaging for 3D hip reconstruction...
January 28, 2019: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Robert M Havey, Saeed Khayatzadeh, Leonard I Voronov, Kenneth R Blank, Gerard Carandang, David P Harding, Avinash G Patwardhan
BACKGROUND: Cervical fusion is associated with adjacent segment degeneration. Cervical disc arthroplasty is considered an alternative to reduce risk of adjacent segment disease. Kinematics after arthroplasty should closely replicate healthy in vivo kinematics to reduce adjacent segment stresses. The purpose of this study was to assess the kinematics of a polycrystalline diamond cervical disc prosthesis. METHODS: Nine cadaveric C3-T1 spines were tested intact and after one (C5-C6) and two level (C5-C7) arthroplasty (Triadyme-C, Dymicron Inc...
January 4, 2019: Clinical Biomechanics
Ebru Oral, Keith K Wannomae, David A Bichara, Brad Micheli, Brinda N Doshi, Caitlin O'Brien, G Petur Nielsen, Orhun K Muratoglu
Chemical cross-linking of ultrahigh molecular weight polyethylene (UHMWPE) using an organic peroxide followed by high temperature melting results in a large increase in toughness accompanied by a decrease in cross-link density, which, surprisingly does not compromise the wear resistance. We compared the mechanical properties and wear behavior of a vitamin E blended, chemically cross-linked and high temperature melted UHMWPE produced by ram extrusion (PRX HTM) to those measured with the clinically available 100-kGy irradiated and melted UHMWPE (CISM 100)...
December 26, 2018: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
Xu-Dong Cui, Hai-Tao Li, Wen Zhang, Lin-Lin Zhang, Zong-Ping Luo, Hui-Lin Yang
BACKGROUND: Lumbar total disc replacement (TDR) has shown satisfactory clinical outcomes with few complications and reoperations at short-term follow-up, but the mid- to long-term results are not clear. PURPOSE: The objective of this study was to evaluate the mid- to long-term clinical outcomes of artificial TDR for lumbar degenerative disc diseases. PATIENTS AND METHODS: A systematic search was conducted using the PubMed database to identify studies of TDR surgery that included at least 3 years of follow-up...
December 26, 2018: Journal of Orthopaedic Surgery and Research
Chih-Chang Chang, Wen-Cheng Huang, Jau-Ching Wu, Praveen V Mummaneni
Cervical disc arthroplasty (CDA), or total disc replacement, has emerged as an option in the past two decades for the management of 1- and 2-level cervical disc herniation and spondylosis causing radiculopathy, myelopathy, or both. Multiple prospective randomized controlled trials have demonstrated CDA to be as safe and effective as anterior cervical discectomy and fusion, which has been the standard of care for decades. Moreover, CDA successfully preserved segmental mobility in the majority of surgical levels for 5-10 years...
December 14, 2018: Neurospine
(no author information available yet)
OBJECTIVEThe long-term efficacy of artificial disc replacement (ADR) surgery compared with fusion after decompression for the treatment of cervical degenerative disc disease and radiculopathy has not previously been investigated in a population-based setting.METHODSAll patients with cervical degenerative disc disease and radiculopathy who were in the national Swedish Spine Registry (Swespine) beginning in January 1, 2006, were eligible for the study. Follow-up information was obtained up to November 15, 2017...
October 1, 2018: Journal of Neurosurgery. Spine
Cedric Baltus, Emmanuel Costa, Geraldo Vaz, Christian Raftopoulos
BACKGROUND: Cervical Total Disc Arthroplasty (TDA) or cervical artificial disc replacement (C-ADR) is an alternative technique to anterior cervical discectomy and fusion (ACDF) for the treatment of symptomatic degenerative cervical spine disease. The main goal of TDA is to maintain cervical motion and therefore lower the risk of adjacent levels' deterioration. Granuloma formation on a cervical TDA is exceptional. We report such a case. CLINICAL PRESENTATION: A 48-year-old female suffering from left cervico-brachialgia underwent a double-level TDA (SpinalKinetics® M6-C Artificial Cervical Disc) on C5-C6 and C6-C7 in another hospital in 2010...
November 17, 2018: World Neurosurgery
Vladimir Kovač
PURPOSE: To analyze and clarify conflicting aspects of fusion and total disc replacement (TDR) surgery in literature. METHOD: Using keywords, 23 literature reviews, 41 studies accepted by "importance criteria" from the Internet, and 16 articles "published in 2018" were chosen. Altogether 80 studies. RESULTS: General assessment was mentioned as affirmative for TDR in 40 papers, five were negative, 24 without clear decision...
November 13, 2018: International Orthopaedics
J L Berliner, C I Esposito, T T Miller, D E Padgett, D J Mayman, S A Jerabek
AIMS: The aims of this study were to measure sagittal standing and sitting lumbar-pelvic-femoral alignment in patients before and following total hip arthroplasty (THA), and to consider what preoperative factors may influence a change in postoperative pelvic position. PATIENTS AND METHODS: A total of 161 patients were considered for inclusion. Patients had a mean age of the remaining 61 years (sd 11) with a mean body mass index (BMI) of 28 kg/m2 (sd 6). Of the 161 patients, 82 were male (51%)...
October 2018: Bone & Joint Journal
Alexander Vaccaro, William Beutler, Walter Peppelman, Joseph Marzluff, Andrew Mugglin, Prem S Ramakrishnan, Jacqueline Myer, Kelly J Baker
Background: This research was initiated to compare the long-term clinical safety and effectiveness of the selectively constrained SECURE-C (Globus Medical, Audubon, Pennsylvania) Cervical Artificial Disc to anterior cervical discectomy and fusion (ACDF). To preserve segmental motion, cervical total disc replacement (CTDR) was developed as an alternative to ACDF. Current CTDR designs incorporate constrained and unconstrained metal-on-metal or metal-on-polymer articulation with various means of fixation...
June 2018: International Journal of Spine Surgery
Leonard I Voronov, Robert M Havey, Parmenion P Tsitsopoulos, Saeed Khayatzadeh, Jeremy Goodsitt, Gerard Carandang, Alexander J Ghanayem, Avinash G Patwardhan
Background: The need for posterior longitudinal ligament (PLL) resection during cervical total disc arthroplasty (TDA) has been debated. The purpose of this laboratory study was to investigate the effect of PLL resection on cervical kinematics after TDA. Methods: Eight cadaveric cervical spine specimens were tested in flexion-extension (FE), lateral bending (LB), and axial rotation (AR) to moments of ±1.5 Nm. After testing the intact condition, anterior C5-C6 cervical discectomy was performed followed by PLL resection and implantation of a compressible, 6-degrees-of-freedom disc prosthesis (M6-C, Spinal Kinetics Inc, Sunnyvale, California)...
April 2018: International Journal of Spine Surgery
Junfeng Zeng, Hao Liu, Hua Chen, Chen Ding, Xin Rong, Yang Meng, Yi Yang
OBJECTIVE: To compare the heterotopic ossification (HO) between cervical disc arthroplasty (CDA) with fixed- and mobile-core prosthesis and to compare the clinical and radiographic outcomes. METHODS: This was a retrospective analysis of patients who underwent CDA in our institute. Patients were divided into a fixed-core group (Prodisc-C and Discover disc) and mobile-core group (Bryan and Prestige-LP disc). HO was assessed based on the McAfee classification. The visual analogue scale, Neck Disability Index, and Japanese Orthopaedic Association scores were used to evaluate clinical outcomes...
December 2018: World Neurosurgery
Wen-Ming Chen, Jie Jin, Taehyung Park, Kyeong-Sik Ryu, Sung-Jae Lee
BACKGROUND: Postoperative alterations in cervical spine curvature (i.e. loss of lordotic angle) are frequently observed following total disc replacement surgery. However, it remains unclear whether such changes in lordotic angle are due to preoperative spinal deformities and/or prostheses design limitations. The objective of the study is to investigate strain and segmental biomechanics of the malaligned cervical spine following total disc replacement. METHODS: Three disc prostheses were chosen, namely a metal-on-polyethylene, a metal-on-metal, and an elastomeric prosthesis, which feature different geometrical and material design characteristics...
August 10, 2018: Clinical Biomechanics
Junfeng Zeng, Hao Liu, Xin Rong, Beiyu Wang, Yi Yang, Xinlin Gao, Tingkui Wu, Ying Hong
BACKGROUND: Cervical disc arthroplasty (CDA) has been considered as an alternative to cervical arthrodesis in the treatment of cervical degenerative disc diseases (CDDD). The aim of this study was to assess the long-term clinical and radiographic outcomes of CDA with Prestige-LP Disc. METHODS: A total of 61 patients who underwent single- or two-level CDA with Prestige-LP Disc were retrospectively investigated at a minimum of 6-year follow-up. Clinical assessments included visual analogue scale (VAS) for neck and arm pain, Neck Disability Index (NDI), and Japanese Orthopedic Association (JOA) score...
August 7, 2018: BMC Musculoskeletal Disorders
Azeem Tariq Malik, Nikhil Jain, Jeffery Kim, Elizabeth Yu, Safdar N Khan
STUDY DESIGN: Retrospective review of prospective registry OBJECTIVE.: To analyze the impact of metabolic syndrome (MetS) on 30-day outcomes following elective anterior cervical discectomy and fusions (ACDFs). SUMMARY OF BACKGROUND DATA: MetS is defined as the presence of a combination of hypertension, diabetes mellitus and obesity. Past literature has reported MetS to complicate post-operative care in patients undergoing various surgical procedures, including lumbar fusions...
August 2, 2018: Spine
Anna MacDowall, Martin Skeppholm, Lars Lindhagen, Yohan Robinson, Claes Olerud
OBJECTIVE: Several efforts have been made to investigate the long-term efficacy of artificial disc replacement surgery compared with that of fusion after decompression for the treatment of cervical degenerative disc disease and radiculopathy. However, research on the impact of mental distress on surgical treatment outcome has been sparse. The aim of the authors was to investigate the potential predictive value of preoperative risk factors in determining long-term outcome. METHODS: A total of 153 patients (mean age 47 years) with single- or double-level cervical degenerative disc disease and radiculopathy were randomly assigned to undergo either anterior cervical discectomy and fusion (n = 70) or artificial disc replacement (n = 83)...
October 2018: Journal of Neurosurgery. Spine
Christoph-Heinrich Hoffmann, Jens Castein, Frank Kandziora
Although total disc arthroplasty (TDA) is a common procedure for selected cases of degenerative disc disease, until today there are only two cases of TDA infections reported in the literature. We report three cases of postoperative TDA infections, two developed cutaneous fistulas. To eradicate the infectious site, a staged removal of the device, resolute debridement, and stabilization plus fusion is proposed. Surgeons are challenged by (1) major retroperitoneal vessels adherent to the device, (2) surrounding scar tissue, (3) accompanying retroperitoneal abscess, and (4) technical issues when removing and replacing the implant...
June 19, 2018: European Spine Journal
Comron Saifi, Alejandro Cazzulino, Caroline Park, Joseph Laratta, Philip K Louie, Jamal N Shillingford, Ronald Lehman, Howard An, Frank Phillips
Study Design: Retrospective database study. Objectives: Analysis of economic and demographic data concerning lumbar disc arthroplasty (LDA) throughout the United States to improve value-based care and health care utilization. Methods: The National Inpatient Sample database was queried for patients who underwent primary or revision LDA between 2005 and 2013. Demographic and economic data included total surgeries, costs, length of stay, and frequency of routine discharge...
April 2018: Global Spine Journal
Lin-Nan Wang, Bo-Wen Hu, Lei Wang, Yue-Ming Song, Xi Yang, Li-Min Liu, Hao Liu
BACKGROUND: To evaluate the mid- to long-term clinical and radiographic outcomes of anterior cervical discectomy and dynamic cervical implant (DCI) arthroplasty for degenerative cervical disc disease. METHODS: From April 2010 to October 2010, 38 patients with single- or double-level cervical disc herniation underwent anterior cervical discectomy and DCI arthroplasty. The clinical results and radiographic outcomes of these 38 patients (42 levels) were retrospectively evaluated...
April 4, 2018: BMC Musculoskeletal Disorders
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