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Subsidence of SB Charité total disc replacement and the role of undersizing

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Abstract

Purpose

A possible complication after total disc replacement (TDR) is subsidence, presumably caused by asymmetric implantation, implant undersizing or reduced bone quality. This study aims to quantify the degree of subsidence of an SB Charité TDR, and investigate whether undersizing is related to subsidence.

Methods

A custom developed software package (Mathworks) reconstructed 3D bone-implant geometry. A threshold for subsidence was determined by comparing penetrated bone volume (PBV) and rotation angles. Inter- and intra-observer reproducibilities were calculated. Subsidence was correlated to undersizing.

Results

High inter- and intra-observer correlation coefficients were found for the method (R > 0.92). Subsidence was quantified as PBV 700 mm3 combined with a rotation angle >7.5°. A reduced risk of subsidence was correlated to >60 and >62 % of the bony endplate covered by the TDR endplate for L4 and L5, respectively.

Conclusions

A reproducible method to determine undersizing was developed. Thresholds were determined related to a reduced risk of subsidence.

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Conflict of interest

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Maastricht University Medical Center and Research School CAPHRI, P. Debyelaan 25, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands

    Ilona Punt, Lodewijk van Rhijn & Paul Willems

  2. Eindhoven University of Technology, Eindhoven, The Netherlands

    Marc van Rijsbergen, Bert van Rietbergen & Keita Ito

  3. VieCuri Medical Centre, Venlo, The Netherlands

    André van Ooij

Authors
  1. Ilona Punt
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  2. Marc van Rijsbergen
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  3. Bert van Rietbergen
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  4. Keita Ito
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  5. Lodewijk van Rhijn
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  6. André van Ooij
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  7. Paul Willems
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Correspondence to Ilona Punt.

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Punt, I., van Rijsbergen, M., van Rietbergen, B. et al. Subsidence of SB Charité total disc replacement and the role of undersizing. Eur Spine J 22, 2264–2270 (2013). https://doi.org/10.1007/s00586-013-2864-8

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  • DOI: https://doi.org/10.1007/s00586-013-2864-8

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