title: Charité total disc replacement--clinical and radiographical results after an average follow-up of 17 years.
abstract: A retrospective clinical-radiological study to evaluate the long-term outcome after artificial disc replacement was performed. The objective is to investigate long-term results after implantation of a modular type artificial disc prosthesis in patients with degenerative disc disease (DDD). Total disc replacement (TDR) is a surgical procedure intended to save segmental spinal function, and thus replace spondylodesis. Short-term results are promising, whereas long-term results are scarce. The Charité TDR is the oldest existing implant, therefore, the longest possible follow-up is presented here. Seventy-one patients were treated with 84 Charité TDRs types I-III. Indication for TDR was moderate to severe DDD. Fifty-three patients (63 TDRs) were available for long-term follow-up of 17 years. Evaluation included Oswestry disability index, visual analog scale, overall outcome score, plain and extension/flexion radiographs. Implantation of Charité TDR resulted in a 60% rate of spontaneous ankylosis after 17 years. No significant difference between the three types of prostheses was found concerning clinical outcome. Reoperation was necessary in 11% of patients. Although no adjacent segment degeneration was observed in the functional implants (17%), these patients were significantly less satisfied than those with spontaneous ankylosis. TDR, nowadays, is an approved procedure. Proof that long-term results of TDR implantation in DDD are at least as good as fusion results is still missing.
authors.affiliation: Center for Musculoskeletal Surgery, Charité-University Medicine Berlin, Schumannstrasse 20/21, 10117 Berlin, Germany. michael.putzier@charite.de
authors.forename: Michael
authors.initials: M
authors.lastname: Putzier
authors.forename: Julia F
authors.initials: JF
authors.lastname: Funk
authors.forename: Sascha V
authors.initials: SV
authors.lastname: Schneider
authors.forename: Christian
authors.initials: C
authors.lastname: Gross
authors.forename: Stephan W
authors.initials: SW
authors.lastname: Tohtz
authors.forename: Cyrus
authors.initials: C
authors.lastname: Khodadadyan-Klostermann
authors.forename: Carsten
authors.initials: C
authors.lastname: Perka
authors.forename: Frank
authors.initials: F
authors.lastname: Kandziora
mesh_terms: D000328:Adult; D019643:Arthroplasty, Replacement / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome