Open Access, Peer-reviewed
pISSN 2093-4378
eISSN 2093-4386
    J Korean Soc Spine Surg. 2001 Sep;8(3):378-385. Korean.
    Published online Sep 30, 2001.
    https://doi.org/10.4184/jkss.2001.8.3.378
    Copyright © 2001 Korean Society of Spine Surgery
    Review

    Artificial Disc Replacement

    Young-Do Koh, M.D.
      • Department of Orthopaedic Surgery, College of Medicine, Ewha Womans University, Seoul, Korea.
    • Address reprint requests to Young-Do Koh, M.D. Department of Orthopaedic Surgery, College of Medicine, Ewha Womans University, #911-1 Mokdong, Yancheon-ku, Seoul 158-710, Korea. Tel: 82-2-650-5564, Fax: 82-2-2644-0128, Email: ydkoh@mm.ewha.ac.kr

    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.

    Keywords
    Artificial disc replacement

    References

      1. Bao QB, McCullen GM, Higham PA, Dumbleton JH, Yuan HA. The artificial disc: theory, design and materials. Biomaterials 1996;17:1157–1167.
      1. 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 1987;125:1–6.
      1. Büttner-Janz K, Schellnack K, Zippel H. Biomechanics of the SB Charité lumbar intervertebral disc endoprothesis. Int Orthop 1989;13:173–176.
      1. Büttner-Janz K, Schellnack K, Zippel H, Conrad P. Experience and results with the SB Charité lumbar intervertebral endoprosthesis. Z. Klin 1988;43(20):1785–1789.
      1. Cinotti G, David T, Postacchini F. Results of disc prothesis after a minimum follow-up period of 2 years. Spine 1996;21:995–1000.
      1. Cyron BW, Hutton WC. Articular tropism and stability of the lumbar spine. Spine 1980;5:168–172.
      1. David T. Surgical technique, indications and clinical results in 22 patients with a minimum of 12 months follow-up. Eur Spine 1993;1:254–259.
      1. Edeland H.G. Plan logique d'une prothese du disque intervertebral. Conditions biomecaniques et biomateriaux requis. Acta Orthop Beg 1981;47:130–134.
      1. Eijkelkamp MF, Donkelaar VCC, Veldhuizen AG, Horn VJR, Huyghe JM, Verkerke CJ. Requirements for an artificial intervertebral disc. The Int J Artif Organs 2001;24:311–321.
      1. Enker P, FRCS, Steffee A, Mcmillin C, Keppler L, Biscup R, Miller S. Artificial Disc Replacement. Spine 1993;18:1061–1070.
      1. Fassio B, Ginestie JF. Prothese discale en silicone. Etude experientale et premieres observations cliniques. Nouv Presse Med 1978;21:207.
      1. Fernström U. Arthroplasty with intercorporal endoprocthesis in herniated disc an in painful disc. Acta Chir Scand Suppl 1966;357:154–159.
      1. Fernström U. Arthroplasy with intercorporalendoprosthesis in herniated and painful disc. Acta Chir Scand 1973;4:165–186.
      1. 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; 1992. pp. 227-236.
      1. Griffith SL, Shelokov AP, B ttner-Janz K, LeMaire JP, Zeegers WS. Multicentric retrospective study of the clinical result of Link® SB Charit intervertebral prosthesis. The initial European experience. Spine 1994;19:1842–1849.
      1. Harms J, Hess H. Indikation, operative problematik und Ergebnisse der Renukleotomie. Z. Orthop 1974;112:824–825.
      1. Hedman TP, Kostuik JP, Femie GR, Hellier WG. Disign of an intervertebral disc prosthesis. Spine 1991;16:256–260.
      1. Hoffmann-Daimler S. Zur Frage des Bandscheibenersatzes. Z Orthop 1974;112:792–795.
      1. Jackson RK, Boston DA, Edge AJ. Lateral mass fusion. A prospective study of a consecutive series with long term follow up. Spine 1985;10:828–832.
      1. King AI, Prasad P, Ewing CL. Mechanism of spinal injury due to cephalocaudad acceleration. Orthop Clin North Am 1975;6:19–31.
      1. Kiviluoto O, Santavirta S, Salenious P, Morri P, Pylkkannen p. Posterolateral spine fusion. A 1-4 year follow up of 80 consecutive patients. Acta Orthop Scand 1985;56:152–154.
      1. Lee CK. Accelerated degeneration of the segment adjacent to a lumbar fusion. Spine 1988;13:375–377.
      1. Lee CK, Langrana NA, Parsons JR, Zimmerman MC. Development of a prosthetic intervertebral disc. Spine 1991;16:253–260.
      1. 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; 1992. pp. 237-244.
      1. Lehmann TR, Spratt KF, Tozzi JE. Long-term follow-up of lower lumbar fusion patients. Spine 1987;12:97–104.
      1. Lemaire JP, Skalli W, Lavaste F, Templier A, Mendes F, Diop A, Sauty V, Laloux E. Intervertebral disc prosthesis. Clin Orthop 1997;337:64–76.
      1. 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 1996;21:184–189.
      1. Mckenzie AH. Fernström intervertebral disc arthplasty: a long term evaluation. Orth Int ed 1995;3(4):313–324.
      1. 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; 1992. pp. 271-278.
      1. O'Beirne J, O'Neill D, Williams DH. Spinal fusion for back pain: A clinical and radiological review. J Spinal Discord 1992;5:32–38.
      1. Schmitt O, Fritsch E, Hassinger M, Schnitt E. Epikritische Langzeitergebnisstudie nach lumbaler Bandscheibenoperation aus den Jahren .1965-1979. Z. Orthop 1983:121–393.
      1. Schneider PG, Oyen R. Plastische Bandschdiben-chirurgie. I. Mitteilung:Bandscheibenersatz im lumbalen Bereich mit Silikonkauschuk. Theoretische und experimentelle Untersuchungen. Z. Orthop 1974;112:1078–1086.
      1. Schuler P, Clemns D, Rossak K. Nachuntersuchung-sergebnisse nach lumbalen Renukleotomien. Z. Orthop 1983;121:33–36.
      1. Schulman CM. Metod kombinirowannogo chirurgisches-kogo letschenija kompressionnych form pojasnitschnogo osteochondrosa a alloprotesirowaniem porashennych meshposwonkowych diskow. Vop Neirokhr 1977;2:17–23.
      1. Stauffer RN, Coventry MB. Posterolateral lumbar spine fusion. Analysis of Mayo Clinic series. J Bone and Joint Surg Am 1972:1195–1204.
      1. Steenbrugghe VMH. In: Perfectionnements auxéproth sis articulaires [Improvements in articular prostheses] FR-PS. pp. 1.122.634-28.5.56.
      1. Steffee A. In: Artificial disc. Elastomer core between flat rigid plate. 1991. US Patent No 5071437.
      1. Suzuki T, Pearcy MJ, Tibrewal SB, Wilson D, Duthie RB. Posterior intertransverse fusion assessed clinically and with biplanar radiography. Int Orthop 1985;9:11–17.
      1. Walker N, Kehr P. Discushernien-operationen. Langzeitverlufe nach lumbaler Diskushernien-Operation. Orthopäde 1979;8:211–214.
      1. Wittig C, Müller RT. Erste Erfahrungen mir der Bandscheibenprothese SB Charité. Klinikarzt 1983;17:712–720.
      1. Wittig C, Müller RT, Staudte HW, Behrens K. Bandscheibenprothese SB Charité, Erfolge und Miβerfolge an hand von Frühergebnisse. Med Orthop Technik 1989;109:70–74.
      1. 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 1999;8:210–217.
      1. Zippel H. "Charité Modular": Conception, Experience and Results. In: Brook M, Mayer HM, Weigel K, editors. The artificial disc. Springer-Verlag; 1991. pp. 69-78.
    MeSH Terms
    Corrosion
    Diskectomy
    Follow-Up Studies
    Low Back Pain
    Osteoporosis
    Pathology
    Patient Selection
    Spinal Stenosis
    Spine
    Spondylolisthesis
    Spondylosis
    Total Disc Replacement*
    Zygapophyseal Joint
    Metrics
    Share
    PERMALINK