Intervertebral disc replacement. Experimental study.
Arthrodesis of the lumbosacral spine, although satisfactory for a majority of patients, has long term sequelae in 30% of patients. This is particularly true for adjacent segment degeneration. Numerous attempts at providing a mobile motion segment have been made in the past. The current status of the development of dynamic intervertebral prosthesis, including biomechanical and clinical data have been presented. The relevant material properties of plastics, ceramics, and metal are presented with the conclusion that metals currently present with the greatest longevity without undue fatigue and wear as many as 100,000,000 cycles (40 years use) as an alternative to spinal fusion. An analysis of the kinematics of the motion segment have resulted, together with the material properties in the development of a dynamic intervertebral disc for use in the lumbar spine. The disc resembles a normal motion segment. In motion stiffness and center of rotation, wear debris development in 1/300 equivalent to that of a total hip prosthesis for the same given time. Safety features include immediate screw fixation to prevent displacement, a wedge elastic (spring) shape, and a bony porous ingrowth surface. The prosthesis is constructed of cobalt chromium and titanium with minimal corrosive properties on long term testing.
Kostuik
J P
JP
Department of Orthopedic Surgery, Johns Hopkins Hospital, Baltimore, MD 21287-0882, USA.
D000818:Animals; D001696:Biomechanical Phenomena; D002858:Chromium Alloys; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D008422:Materials Testing; D011095:Polyethylenes; D019736:Prostheses and Implants; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D012756:Sheep; D013122:Spinal Diseases / Q000503:physiopathology / Q000601:surgery*; D016474:Weight-Bearing
D002858:Chromium Alloys; D011095:Polyethylenes