Download PDF
Semin Musculoskelet Radiol 2006; 10(1): 022-029
DOI: 10.1055/s-2006-934214
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Lumbar Disc Replacement

Cheryl A. Petersilge1 , 2
  • 1St. Elizabeth Hospital, Youngstown, Ohio
  • 2Case Western Reserve University School of Medicine, Cleveland, Ohio
Further Information

Publication History

Publication Date:
03 March 2006 (online)

Also available at
    Permissions and Reprints

ABSTRACT

Lumbar disc replacement is a developing primary surgical treatment for patients with degenerative disc disease. The goals of disc arthroplasty are to remove the native nucleus pulposus and to preserve motion at that disc level. Devices being developed include artificial replacement of the nucleus pulposus and artificial replacement of the entire disc. With the recent approval by the Food and Drug Administration of the Charite artificial disc, this procedure will be used with increasing frequency. This article reviews pertinent anatomy and pathology of the functional spinal unit as well as the types of devices being developed and the factors related to development of a successful implant. Clinical outcomes and complications are also discussed.

KEYWORDS

Disc arthroplasty - disc replacement - artificial disc - disc degeneration - low back pain

REFERENCES

  • 1 Bao Q B, McCullen G M, Higham P A, Dumbleton J H, Yuan H A. The artificial disc: theory, design and materials.  Biomaterials. 1996;  17 1157-1167
    CrossrefPubMedGoogle Scholar
  • 2 Lee C K. Accelerated degeneration of the segment adjacent to a lumbar fusion.  Spine. 1988;  13 375-377
    CrossrefPubMedGoogle Scholar
  • 3 Lehmann T R, Spratt K F, Tozzi J E et al.. Long term follow up of lower lumbar fusion patients.  Spine. 1987;  12 97-104
    PubMedGoogle Scholar
  • 4 Schlegel J D, Smith J A, Schleusener R L. Lumbar motion segment pathology adjacent to thoracolumbar, lumbar and lumbosacral fusions.  Spine. 1996;  21 970-981
    CrossrefPubMedGoogle Scholar
  • 5 Blumenthal S L, Ohnmeiss D D, Guyer R et al.. Artificial intervertebral discs and beyond: a North American Spine Society Annual Meeting symposium.  Spine J. 2002;  2 460-463
    CrossrefPubMedGoogle Scholar
  • 6 Bono C M, Garfin S R. History and evolution of disc replacement.  Spine J. 2004;  4(6 Suppl) 145S-150S
    CrossrefPubMedGoogle Scholar
  • 7 Szpalski M, Gunzburg R, Mayer M. Spine arthroplasty: a historical review.  Eur Spine J. 2002;  11 S65-S84
    PubMedGoogle Scholar
  • 8 Dooris A P, Goel V K, Grosland N M, Gilbertson L G, Wilder D G. Load-sharing between anterior and posterior elements in a lumbar motion segment implanted with an artificial disc.  Spine. 2001;  26 E122-E129 Available at: http://gateway1.ovid.com/ovidweb.cgi Accessed February 12, 2004; 
    CrossrefPubMedGoogle Scholar
  • 9 Link H. History, design and biomechanis of the LINK SB Charite artificial disc.  Eur Spine J. 2002;  (11 suppl 2) S98-S105
    PubMedGoogle Scholar
  • 10 Pearcy M J, Bogduk N. Instantaneous axes of rotation of the lumbar intervertebral joints.  Spine. 1988;  13 1033-1041
    PubMedGoogle Scholar
  • 11 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
    PubMedGoogle Scholar
  • 12 Bertagnoli R, Kumar S. Indications for full prosthetic disc arthroplasty: a correlation of clinical outcome against a variety of indications.  Eur Spine J. 2002;  11(Suppl 2) S131-S136
    PubMedGoogle Scholar
  • 13 Enker P, Steffee A, McMillin C, Kepplrt L, Biscup R, Miller S. Artificial disc replacement: preliminary report with a 3 year minimum follow-up.  Spine. 1993;  18 1061-1070
    PubMedGoogle Scholar
  • 14 Griffith S L, Shelokov A P, Buttner-Janz K, Lemaire J P, Zeegers W S. A multicenter retrospective study of the clinical results of the link intervertebral prosthesis. The initial European experience.  Spine. 1994;  19 1842-1849
    PubMedGoogle Scholar
  • 15 McAfee P C. The indications for lumbar and cervical disc replacement.  Spine J. 2004;  4 177S-181S
    CrossrefPubMedGoogle Scholar
  • 16 Hochschuler S H, Ohnmeiss D D, Guyer R D, Blumenthal S L. Artificial disc: preliminary results in a prospective study in the United States.  Eur Spine J. 2002;  11 S106-S110
    PubMedGoogle Scholar
  • 17 McAfee P C, Fedder I L, Saiedy S, Shucosky E M, Cunningham B W. Experimental design of total disk replacement-experience with a prospective randomized study of the SB Charite.  Spine. 2003;  28 S153-S162
    CrossrefPubMedGoogle Scholar
  • 18 Hedman T P, Kostuik J P, Fernie G R et al.. Design of an intervertebral disc prosthesis.  Spine. 1991;  16 S256-S260
    CrossrefPubMedGoogle Scholar
  • 19 Cinotti G, David T, Postacchini F. Results of the disc prosthesis after a minimum follow up period of 2 years.  Spine. 1996;  21 995-1000
    CrossrefPubMedGoogle Scholar
  • 20 Zeegers W S, Bohnen LMI, Laaper M, Verhaegen MJA. Artificial disc replacement with the modular type SC Charite III: 2-year results in 50 prospectively studied patients.  Eur Spine J. 1999;  8 210-217
    CrossrefPubMedGoogle Scholar
  • 21 Lee CK, Goel VK. Artificial disc prosthesis: design concepts and criteria.  Spine J. 2004;  4 209S-218S
    CrossrefPubMedGoogle Scholar
  • 22 Carl A, Ledet E, Yuan H, Sharan A. New developments in nucleus pulposus replacement technology.  Spine J. 2004;  4 325S-329S
    CrossrefPubMedGoogle Scholar
  • 23 Sieber A N, Kostiuk J P. Concepts in nuclear replacement.  Spine J. 2004;  4 322S-324S
    CrossrefPubMedGoogle Scholar
  • 24 Eijkelkamp M F, van Donkelaar C C, Veldhuizen A G, van Horn J R, Huyghe J M. Requirements for an artificial intervertebral disc.  Int J Artif Organs. 2001;  24 311-321
    PubMedGoogle Scholar
  • 25 Eijkelkamp M F, Hyen J, Veldhuizen A G, van Horn J R, Verkerke G J. Improving the fixation of an artificial intervertebral disc.  Int J Artif Organs. 2002;  25 327-333
    PubMedGoogle Scholar
  • 26 Van Ooij A, Oner F C, Verbout A J. Complications of artificial disc replacement a report of 27 patients with the SB Charite disc.  J Spinal Disord. 2003;  16 369-383
    PubMedGoogle Scholar
  • 27 FDA approves artificial disc; another alternative to treat low back pain. Available at: http://www.fda.gov/bbs/topics/ANSWERS/2004/ANS01320.html Accessed January 4, 2005
    Google Scholar
  • 28 Errico T J. Why a mechanical disc?.  Spine J. 2004;  4 151S-157S
    CrossrefPubMedGoogle Scholar
  • 29 Zigler J E. Lumbar spine arthroplasty using the ProDisc II.  Spine J. 2004;  4 260S-267S
    CrossrefPubMedGoogle Scholar
  • 30 Mathews H H, LeHuec J C, Friesem T, Zdeblick T, Eisermann L. Design rationale and biomechanics of Maverick Total Disc arthroplasty with early clinical results.  Spine J. 2004;  4 268S-275S
    CrossrefPubMedGoogle Scholar
  • 31 Valdevit A, Errico T J. Design and evaluation of the FlexiCore metal-on-metal intervertebral disc prosthesis.  Spine J. 2004;  4 276S-288S
    CrossrefPubMedGoogle Scholar
  • 32 Guyer R D, McAfee P C, Hochschuler S H et al.. Prospective randomized study of the Charite artificial disc: data from two investigational centers.  Spine J. 2004;  4 252S-259S
    CrossrefPubMedGoogle Scholar
  • 33 McAfee P C, Cunningham B W, Devine J, Williams E, Yu-Yahiro J. Classification of heterotopic ossification (HO) in artificial disk replacement.  J Spinal Disord Tech. 2003;  16 384-389
    CrossrefPubMedGoogle Scholar

Cheryl Ann PetersilgeM.D. 

7775 Thistle Lane, Novelty, OH 44072

      >