CHARITE versus ProDisc: a comparative study of a minimum 3-year follow-up.
METHODS
A retrospective study.


OBJECTIVE
To evaluate and compare clinical and radiologic outcomes of the CHARITE and ProDisc.


BACKGROUND
There is no clinical report comparing CHARITE and ProDisc.


METHODS
Among a total of 61 patients who underwent total disc replacement, 57 patients followed more than 3 years were enrolled. The CHARITE was used in 33 patients and ProDisc in 24. MRI follow-up was possible in 52 patients. Clinical and radiologic data including range of motion (ROM) and facet degeneration of the replaced segment, and degeneration of the disc at the adjacent level were evaluated.


RESULTS
Mean percentage improvement of Oswestry Disability Index (ODI) score was 78.9% in the CHARITE group and 75.8% in ProDisc group. The mean improvement of the Visual Analogue Scale (VAS) pain score was 72% in the CHARITE and 74.2% in ProDisc. There was no statistical difference between 2 groups in improvement rates either of the ODI scores and VAS scores. Degradation of the facets was seen in 36.4% of the CHARITE and 32% of the ProDisc. Degradation of disc degeneration at the adjacent level above the index level was seen in 19.4% in the CHARITE and 28.6% in the ProDisc. The degradation rates of facet joints and disc at adjacent segment between the 2 groups were not significantly different. Segmental ROM of the replaced segments was well preserved, but ROM of L5-S1 of the ProDisc was significantly less than that of the CHARITE.


CONCLUSIONS
While clinical outcomes of both CHARITE and ProDisc groups were fairly good, the facet joint of the index level and the disc at the adjacent level showed an aggravation of the degenerative process in a significant number of patients, regardless of the device used, raising concerns of possible late consequences of total disc replacement, especially regarding facet arthrosis and adjacent segment disease.
Shim
Chan Shik
CS
Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea. shimcs@wooridul.co.kr
Lee
Sang-Ho
SH
Shin
Ho-Dong
HD
Kang
Han Sug
HS
Choi
Won-Chul
WC
Jung
Byungjoo
B
Choi
Gun
G
Ahn
Yong
Y
Lee
Seungcheol
S
Lee
Ho Yeon
HY
D000328:Adult; D000368:Aged; D001416:Back Pain / Q000209:etiology; D004185:Disability Evaluation; D017586:Diskectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome