Abstract
The intervertebral disc prosthesis seems to have gained its place in spinal surgery. The first 45 disc replacements (36 patients) performed at our institution have been followed for 5–9 years with standard radiography, CT, MRI and clinical evaluation. Two prostheses failed and needed further surgery. The mean Oswestry Disability Index score dropped from 44% to 9% and the pain score recorded on a visual analogic scale (VAS) dropped from 8 to 1.4. 92% of patients had excellent or good results and gave a positive answer to the question “Would you be ready to sustain again this same surgical procedure?” In 4 cases, a tendency towards prosthesis subsidence was observed. With time, 6 patients showed periprosthetic calcifications. One patient developed retrograde ejaculation. In conclusion, intervertebral disc prosthesis is a well established procedure that achieves good mid-term results, but doubts still remain about the longterm outcome. Care about right indication, eventual complications and assessment of long-term results are key points for the future of this procedure.
Key words: Intervertebral disc prosthesis, Spine, Degenerative disc disease
References
- 1.Buttner-Janz K., Schellnack K., Zippel H., Conrad P. Experience and results with the SB Charité III lumbar interverebral endoprosthesis. Z Klin Med. 1988;43:1785–1789. [Google Scholar]
- 2.David T. Lumbar disc prosthesis. Surgical technique, indications and clinical results in 22 patients with a minimum 12 months follow-up. Eur Spine J. 1993;1:254–259. doi: 10.1007/BF00298370. [DOI] [PubMed] [Google Scholar]
- 3.Cinotti G., David T., Postacchini F. Results of disc prosthesis after a minimum follow-up period of 2 years. Spine. 1996;21:995–1000. doi: 10.1097/00007632-199604150-00015. [DOI] [PubMed] [Google Scholar]
- 4.Lemaire J.P., Skalli W., Lavaste F., et al. Intervertebral disc prosthesis. Results and prospects for the year 2000. Clin Orthop Relat Res. 1997;337:64–76. doi: 10.1097/00003086-199704000-00009. [DOI] [PubMed] [Google Scholar]
- 5.Zeegers W.S., Bohnen L.M.L.J., Laaper M., Verhaegen M.J.A. Artificial disc replacement with the modular type SB Charité III: 2 year results in 50 prospectively studied patients. Eur Spine J. 1999;8:210–217. doi: 10.1007/s005860050160. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Blumenthal S., McAfee P., Guyer R.D., et al. A prospective, randomized, multicenter Food and Drug Administration investigational device exemptions study of lumbar total disc replacement with Charité III artificial disc versus lumbar fusion: part I: evaluation of clinical outcomes. Spine. 2005;14:1565–1575. doi: 10.1097/01.brs.0000170587.32676.0e. [DOI] [PubMed] [Google Scholar]
- 7.McAfee P., Cunninham B., Holsapple G., et al. A prospective, randomized, multicenter Food and Drug Administration investigational device exemptions study of lumbar total disc replacement with Charité III artificial disc versus lumbar fusion: part II: evaluation of radiographic outcomes and correlation of surgical technique accuracy with clinical outcomes. Spine. 2005;14:1576–1583. doi: 10.1097/01.brs.0000170561.25636.1c. [DOI] [PubMed] [Google Scholar]
- 8.Bertagnoli R., Yue J.J., Shah R.V., Nanieva R., et al. The treatment of disabling single-level lumbar discogenic low back pain with total disc arthroplasty utilizing the Prodisc prosthesis: a prospective study with 2-year minimum follow-up. Spine. 2005;30:2230–2236. doi: 10.1097/01.brs.0000182217.87660.40. [DOI] [PubMed] [Google Scholar]
- 9.Regan J. J., McAfee P. C., Blumenthal S. L., et al. Evaluation of Surgical Volume and the Early Experience With Lumbar Total Disc Replacement as Part of the Investigational Device Exemption Study of the Charite Artificial Disc. Spine. 2006;31:2270–2276. doi: 10.1097/01.brs.0000234726.55383.0c. [DOI] [PubMed] [Google Scholar]
- 10.Fairbank J.C., Pynsent P.B. The Oswestry disability index. Spine. 2000;25:2940–2952. doi: 10.1097/00007632-200011150-00017. [DOI] [PubMed] [Google Scholar]
- 11.Fairbank J.C.T., Couper J., Davies J.B. The Oswestry low back pain questionnaire. Physiotherapy. 1980;66:271–273. [PubMed] [Google Scholar]
- 12.McAfee P.C., Cunningham B.W., Devine J., et al. Classification of heterotopic ossification (HO) in artificial disk replacement. J Spinal Disord Tech. 2003;16:384–389. doi: 10.1097/00024720-200308000-00010. [DOI] [PubMed] [Google Scholar]
- 13.Watkins R.G. Surgical approach to the spine. Berlin Heidelberg New York: Springer; 1983. [Google Scholar]
- 14.Gioia G., Mandelli D., Randelli F. L’approccio anteriore retroperitoneale al rachide lombosacrale. G Ital Orthop Traum. 2000;26:135–142. [Google Scholar]
- 15.Putzier M., Funk J., Schneider S.V., et al. Charité total disc replacement — clinical and radiographical results after an average follow-up of 17 years. Eur Spine J. 2006;15:183–195. doi: 10.1007/s00586-005-1022-3. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.Tortolani P.J., McAfee P.C., Cunningham B.W., et al. Prevalence of heterotopic ossification following total disc replacement: a prospective, randomized study of two hundred and seventy-six patients. J Bone Joint Surg Am. 2007;89:82–88. doi: 10.2106/JBJS.F.00432. [DOI] [PubMed] [Google Scholar]
- 17.Sasso R.C., Kenneth Burkus J., LeHuec J.C. Retrograde ejaculation after anterior lumbar interbody fusion: transperitoneal versus retroperitoneal exposure. Spine. 2004;29:106–107. doi: 10.1097/01.BRS.0000107007.31714.77. [DOI] [PubMed] [Google Scholar]
- 18.David T. Long-term results of one-level lumbar arthroplasty: minimum 10-year follow-up of the Charite Artificial Disc in 106 patients. Spine. 2007;32:661–666. doi: 10.1097/01.brs.0000257554.67505.45. [DOI] [PubMed] [Google Scholar]
- 19.Tropiano P., Huang R.C., Girardi F.P., Marnay T. Lumbar disc replacement: preliminary results with Pro Disc II after a minimum follow-up period of 1 year. J Spinal Disord Tech. 2003;16:362–368. doi: 10.1097/00024720-200308000-00008. [DOI] [PubMed] [Google Scholar]
- 20.Siepe C.J., Mayer H.M., Wiechert K., Korge A. Clinical results of total lumbar disc replacement with ProDisc II: three-year results for different indications. Spine. 2006;31:1923–1932. doi: 10.1097/01.brs.0000228780.06569.e8. [DOI] [PubMed] [Google Scholar]
- 21.Vernon-Roberts B., Pirie C.J. Degenerative changes in the intervertebral disc and and their sequelae. Rheum Rehab. 1977;16:13–21. doi: 10.1093/rheumatology/16.1.13. [DOI] [PubMed] [Google Scholar]
- 22.Schulte T.L., Bullmann V., Lerner T., et al. Lumbar disc arthroplasty. Established technique or experimental procedure? Orthopäde. 2005;34:801–813. doi: 10.1007/s00132-005-0834-5. [DOI] [PubMed] [Google Scholar]
