Artificial disc prosthesis: the Link SB ..
Type I Charité total disc prostheses consisted of two highly polished metal endplates and an ultra high molecular weight polyethylene (UHMWPE) sliding core articulating between these endplates. The endplates of this type were 1 mm thick, had 5 respectively later 11 teeth for bony anchorage and were made of URX2CrNiMoN 18.12 steel. The sliding core was manufactured from Chirulen UHMWPE .
Clinical Results of Charité Lumbar Total Disc Replacement
Several pivot or ball type artificial discs have been developed for the lumbar spine. One device, made of metal-hinged plates with an interposed spring, has been tested on sheep with good results. Another device has a polyethylene core and metal endplates with two vertical wings. Patients who received this implant reported good to excellent results.
Seventy-five patients with persistent leg and back pain after insertion of SB Charité disc prosthesis were studied. The causes of persisting pain were thought to be related to the following late-complications: subsidence, migration, wear of the disc prosthesis, facet joint degeneration or adjacent degeneration in various combinations.
Lumbar Arthroplasty CHARITÉ® Artificial Disc - …
In all cases, the prosthesis was implanted without technical difficulties. In five patients (24%), there was minimum residual flow immediately after implantation, through the central portion of the prosthesis, which disappeared at the control Doppler echocardiography prior to discharge. None of the patients needed intensive care and all were discharged on the day after the implant. There were no deaths or other periprocedural complications in this series.
and the Biomechanics of the Link SB Charite Artificial Disc
80. Charite Artificial Disc Comprehensive Training Program. Sponsored by DePuy Spine. The Center for Spine Arthroplasty at the Endo-Surgery Institute, Cincinnati, OH; September 8, 2005.
of the Link SB Charite intervertebral prosthesis
Additionally, for a correct implantation of artificial disc prostheses a nearly complete removal of the remaining disc tissue is mandatory [, , , ]. This process implies the decortication of the vertebral endplates. Consecutively, osteoinductive substances are regularly released into the disc space due to the interruption of the integrity of the bone–cartilage border . In operative spondylodesis, this effect is intended to enhance and promote the osseous consolidation; however, it is unintended in TDR. This undesired process might also have contributed to the high rate of spondylodesis. Finally, since all of the reported patients suffered preoperatively from moderate to severe DDD, a progression of these processes after surgery can be assumed. This may be another cause of ongoing ossification as a result of degenerative changes of segment-related tissue such as bone and ligaments.
Lumbar Arthroplasty CHARIT Artificial Disc - SlideServe
In summary, this long-term follow-up study demonstrates dissatisfying results after artificial disc replacement in the majority of the evaluated cases concerning clinical as well as radiological outcome. The large percentage (83%) of radiologically confirmed fusions of the treated segments shows that the Charité artificial disc replacement cannot guarantee long-term near to normal function of the spinal motion segment in patients with moderate to severe DDD.
Lumbar Arthroplasty CHARIT Artificial Disc - PowerPoint PPT ..
Artificial disc prosthesis show fair to good short- and mid-term results. Long-term results are becoming apparent now, however, the incidence of late complications with this procedure remain poorly understood. In this report we will analyse late complications and discuss our experiences with salvage operations in patients with persistent pain after SB Charité disc prosthesis implantation. Seventy-five patients with persistent leg and back pain after insertion of an artificial disc prosthesis were enrolled in the study. In this negative selection frequently occurring late-complications were subsidence, wear, adjacent disc degeneration, facet joint degeneration and migration. In 15 patients we performed a posterior fusion without disc removal, and in 22 patients we removed 26 prostheses and performed a posterior and anterior fusion. The visual analogue scale (VAS) and Oswestry were examined before the salvage operation and after a follow-up period of at least 1 year, which is not yet available in all patients. The VAS and Oswestry decreased in the posterior group (n = 10) respectively from 8.0 (SD 0.9) to 6.3 (SD 2.1) and from 57.0 (SD 17.0) to 44.6 (SD 20.4); and in the disc removal group (n = 14) respectively from 8.0 (SD 0.9) to 5.6 (SD 2.7) and from 56.3 (SD 14.0) to 43.0 (SD 20.7). Serious late complications may occur following total disc replacement. Removal of the SB Charité artificial disc is feasible but with inherent risks. Removal of the disc prosthesis gives slightly better results than posterior fusion alone after a follow-up of at least 1 year.