J Korean Soc Spine Surg.  2001 Sep;8(3):378-385. 10.4184/jkss.2001.8.3.378.

Artificial Disc Replacement

• Koh YD

• KMID: 2209760
• DOI: http://doi.org/10.4184/jkss.2001.8.3.378

Abstract

The current two most popular spine surgeries, discectomy and fusion, at best address the pathology of low back pain, but significantly change the normal structure and function of the disc and lead to further degeneration of the adjacent segments. Artificial disc replacement (ADR) is considered an alternative to fusion in treatment of the degenerative disc disease. It can restore the normal kinematic and load-shearing properties of diseased lumbar segments, maintaining stability and mobility with relief of pain. Over the past 40 years, a tremendous effort has been made to develop an artificial disc to replace the degenerated disc. Design criteria of artificial disc include endurance, biocompatibility, galvanic corrosion, geometry, constraints, dynamics, implant stability, and fail-safe. The indications of ADR are still not clear. But the principal indications include mono- and bi-segmental instability, the postnucleotomy syndrome, and spondylolisthesis up to Meyerding I after unsuccessful conservative treatment. The contra-indications are osteoporosis, previous or latent local infection, spondylolisthesis greater than Meyerding I, spinal stenosis, as well as degenerative spondylosis, mainly involving facet joints. There have been several reports about clinical results of ADR. The initial results seem to be good, but follow-up is too short for definite conclusions. Accurate patient selection is imperative to obtain good clinical results. Prospective and longer term studies are needed to evaluate the efficacy of ADR. The further development in designs and materials of artificial disc is the most important to duplicate not only the natural form of disc but also its function.

Keyword

Artificial disc replacement

MeSH Terms

Corrosion
Diskectomy
Follow-Up Studies
Low Back Pain
Osteoporosis
Pathology
Patient Selection
Spinal Stenosis
Spine
Spondylolisthesis
Spondylosis
Total Disc Replacement*
Zygapophyseal Joint

Reference

1). Bao QB, McCullen GM, Higham PA, Dumbleton JH, Yuan HA. The artificial disc: theory, design and materials. Biomaterials. 17:1157–1167. 1996.

2). Büttner-Janz K, Schellnack K, Zippel H. An alternative therapeutic strategy using the disk endoprosthesis of the SB Charité modular type in lumbar disc lesions. Z. Orthop. 125:1–6. 1987.

3). Büttner-Janz K, Schellnack K, Zippel H. Biomechanics of the SB Charité lumbar intervertebral disc endo -prothesis. Int Orthop. 13:173–176. 1989.

4). Büttner-Janz K, Schellnack K, Zippel H, Conrad P. Experience and results with the SB Charité lumbar intervertebral endoprosthesis. Z. Klin. 43(20):1785–1789. 1988.

5). Cinotti G, David T, Postacchini F. Results of disc prothesis after a minimum followup period of 2 years. Spine. 21:995–1000. 1996.

6). Cyron BW, Hutton WC. Articular tropism and sta - bility of the lumbar spine. Spine. 5:168–172. 1980.

8). Edeland H.G.Plan logique d'une prothese du disque intervertebral. Conditions biomecaniques et biomateriaux requis. Acta Orthop Belg. 47:130–134. 1981.

7). David T. Surgical technique, indications and clinical results in 22 patients with a minimum of 12 months followup. Eur Spine. 1:254–259. 1993.

9). Eijkelkamp MF, Donkelaar VCC, Veldhuizen AG, Horn VJR, Huyghe JM, Verkerke CJ. Requirements for an artificial intervertebral disc. The Int J Artif Organs. 24:311–321. 2001.

10). Enker P, Steffee A, Mcmillin C, Keppler L, Biscup R, Miller S. Artificial Disc Replacement. Spine. 18:1061–1070. 1993.

11). Fassio B, Ginestie JF. Prothese discale en silicone. Etude experientale et premieres observations cliniques. Nouv Presse Med. 21:207. 1978.

12). Fernström U. Arthroplasty with intercorporal endoproc -thesis in herniated disc an in painful disc. Acta Chir Scand Suppl. 357:154–159. 1966.

13). Fernström U. Arthroplasy with intercorporalendoprosthesis in herniated and painful disc. Acta Chir Scand. 4:165–186. 1973.

14). Frymoyer JW. Indications for consideration of the artificial disc. (in. Weinstein JN, editor. Clinical efficacy and outcome in the diagnosis and treatment of low back pain. New York: Raven Press;p. 227–236. 1992.

15). Griffith SL, Shelokov AP, B ttner-Janz K, LeMaire JP, Zeegers WS. Multicentric retrospective study of the clinical result of Link^® SB Charité intervertebral prosthesis. The initial European experience. Spine. 19:1842–1849. 1994.

16). Harms J, Hess H. Indikation, operative problematik und Ergebnisse der Renukleotomie. Z. Orthop. 112:824–825. 1974.

17). Hedman TP, Kostuik JP, Femie GR, Hellier WG. Disign of an intervertebral disc prosthesis. Spine. 16:256–260. 1991.

18). Hoffmann-Daimler S. Zur Frage des Bandscheibener -satzes. Z Orthop. 112:792–795. 1974.

19). Jackson RK, Boston DA, Edge AJ. Lateral mass fusion. A prospective study of a consecutive series with long term follow up. Spine. 10:828–832. 1985.

20). King AI, Prasad P, Ewing CL. Mechanism of spinal injury due to cephalocaudad acceleration. Orthop Clin North Am. 6:19–31. 1975.

21). Kiviluoto O, Santavirta S, Salenious P, Morri P and Pylkkannen p. Posterolateral spine fusion. A 1-4 year follow up of 80 consecutive patients. Acta Orthop Scand. 56:152–154. 1985.

22). Lee CK. Accelerated degeneration of the segment Adjacent to a lumbar fusion. Spine. 13:375–377. 1988.

23). Lee CK, Langrana NA, Parsons JR, Zimmerman MC. Development of a prosthetic intervertebral disc. Spine. 16:253–260. 1991.

24). Lee CK, Parsons JR, Langrana NA, Zimmerman MC. Scientific basis: relative efficacy of the artificial disc versus spinal fusion. (in. Weinstein JN, editor. Clinical efficacy and outcome in the diagnosis and treatment of low back pain. New York: Raven Press;p. 237–244. 1992.

25). Lehmann TR, Spratt KF, Tozzi JE. Longterm followup of lower lumbar fusion patients. Spine. 12:97–104. 1987.

26). Lemaire JP, Skalli W, Lavaste F, Templier A, Mendes F, Diop A, Sauty V, Laloux E. Intervertebral disc prosthesis. Clin Orthop. 337:64–76. 1997.

27). Matsunaga S, Skou T, Taketomi E, Nakanisi K. Effects of strain distribution in the intervertebral discs on the progression of ossification of the posterior longitudinal ligaments. Spine. 21:184–189. 1996.

28). Mckenzie AH. Fernström intervertebral disc arthplasty: a long term evaluation. Orth Int ed. 3(4):313–324. 1995.

29). Nachemson AL. Challenge of the artificial disc. (in. Weinstein JN, editor. Clinical efficacy and ourcome in the diagnosis and treatment of low back pain. New York: Raven Press;p. 271–278. 1992.

30). O'Beirne J, O'Neill D, Williams DH. Spinal fusion for back pain: A clinical and radiological review. J Spinal Discord. 5:32–38. 1992.

31). Schmitt O, Fritsch E, Hassinger M, Schnitt E. Epi-kritische Langzeitergebnisstudie nach lumbaler Bandschei-benoperation aus den Jahren.1965-1979. Z. Orthop. 121–393. 1983.

32). Schneider PG, Oyen R. Plastische Bandschdiben-chirurgie. I. Mitteilung: Bandscheibenersatz im lumbalen Bereich mit Silikonkauschuk. Theoretische und experi -mentelle Untersuchungen. Z. Orthop. 112:1078–1086. 1974.

33). Schuler P, Clemns D, Rossak K. Nachuntersuchung-sergebnisse nach lumbalen Renukleotomien. Z. Orthop. 121:33–36. 1983.

34). Schulman CM. Metod kombinirowannogo chirurgisches-kogo letschenija kompressionnych form pojasnitschnogo osteochondrosa a alloprotesirowaniem porashennych meshposwonkowych diskow. Vop Neirokhr. 2:17–23. 1977.

35). Stauffer RN, Coventry MB. Posterolateral lumbar spine fusion. Analysis of Mayo Clinic series. J Bone and Joint Surg [AM]. 1195–1204. 1972.

36). Steenbrugghe VMH. Perfectionnements auxéproth sis articulaires [Improvements in articular prostheses] FR-PS 1.122.634-28.5.56.

37). Steffee A. Artificial disc. Elastomer core between flat rigid plate. US Patent No 5071437. 1991.

38). Suzuki T, Pearcy MJ, Tibrewal SB, Wilson D, Duthie RB. Posterior intertransverse fusion assessed clinically and with biplanar radiography. Int Orthop. 9:11–17. 1985.

39). Walker N, Kehr P. Discushernien-operationen. Lang-zeitverläufe nach lumbaler Diskushernien-Operation. Orthopäde. 8:211–214. 1979.

40). Wittig C, Müller RT. Erste Erfahrungen mir der Bandscheibenprothese SB Charité. Klinikarzt. 17:712–720. 1983.

41). Wittig C, Müller RT, Staudte HW, Behrens K. Bandscheibenprothese SB Charité, Erfolge und Mißerfolge an hand von Frühergebnisse. Med Orthop Technik. 109:70–74. 1989.

42). Zeegers WS, Bohnen LMLJ, Laaper M, Verhaegen MJA. Arthricial disc replacement with the modular type SB Charité III: 2-year results in 50 prospectively studied patients. Eur Spine. 8:210–217. 1999.

43). Zippel H. “Charité Modular”: Conception, Experience and Results(in Brook m, Mayer HM, Weigel K eds. The artificial disc. Springer-Verlag;p. 69–78. 1991.