Footprint mismatch in lumbar total disc arthroplasty.
Lumbar disc arthroplasty has become a popular modality for the treatment of degenerative disc disease. The dimensions of the implants are based on early published geometrical measurements of vertebrae; the majority of these were cadaver studies. The fit of the prosthesis in the intervertebral space is of utmost importance. An undersized implant may lead to subsidence, loosening and biomechanical failure due to an incorrect center of rotation. The aim of the present study was to measure the dimensions of lumbar vertebrae based on CT scans and assess the accuracy of match in currently available lumbar disc prostheses. A total of 240 endplates of 120 vertebrae were included in the study. The sagittal and mediolateral diameter of the upper and lower endplates were measured using a digital measuring system. For the levels L4/L5 and L5/S1, an inappropriate size match was noted in 98.8% (Prodisc L) and 97.6% (Charite) with regard to the anteroposterior diameter. Mismatch in the anterior mediolateral diameter was noted in 79.3% (Prodisc L) and 51.2% (Charite) while mismatch in the posterior mediolateral diameter was observed in 91.5% (Prodisc L) and 78% (Charite) of the endplates. Surgeons and manufacturers should be aware of the size mismatch of currently available lumbar disc prostheses, which may endanger the safety and efficacy of the procedure. Larger footprints of currently available total disc arthroplasties are required.
Gstoettner
Michaela
M
Department of Orthopaedic Surgery, Medical University Innsbruck, Innsbruck, Austria.
Michaela
Gstoettner
G
Heider
Denise
D
Denise
Heider
H
Liebensteiner
Michael
M
Bach
Christian Michael
CM
Michael
Bach Christian
BC
D000328:Adult; D000368:Aged; D000886:Anthropometry / Q000379:methods; D001178:Arthroplasty / Q000009:adverse effects / Q000295:instrumentation* / Q000592:standards*; D004867:Equipment Design / Q000592:standards; D004868:Equipment Failure; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D017116:Low Back Pain / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D011300:Preoperative Care / Q000592:standards; D019736:Prostheses and Implants / Q000009:adverse effects / Q000592:standards*; D014057:Tomography, X-Ray Computed / Q000379:methods
Spine (Phila Pa 1976). 2007 Apr 20;32(9):1001-11
17450076
Bone. 2001 May;28(5):563-71
11344057
Spine (Phila Pa 1976). 2005 Mar 15;30(6):638-44
15770178
J Spinal Disord Tech. 2003 Aug;16(4):369-83
12902953
J Anat. 1985 Dec;143:115-20
3870717
J Orthop Res. 2002 Sep;20(5):1115-20
12382980
Eur Spine J. 2003 Dec;12(6):556-61
12783287
J Spinal Disord Tech. 2003 Aug;16(4):412-7
12902958
Spine (Phila Pa 1976). 2005 Oct 1;30(19):E556-61
16205328
Eur Spine J. 2008 Jan;17(1):36-43
17929065
Eur Spine J. 2000 Jun;9(3):242-8
10905444
Br J Radiol. 1985 Nov;58(695):1031-4
3842609
Calcif Tissue Res. 1969;3(2):163-75
5769902
Eur Spine J. 2003 Aug;12(4):413-20
12955610
Spine (Phila Pa 1976). 1996 May 1;21(9):1032-6
8724086
Spine (Phila Pa 1976). 2007 Apr 1;32(7):782-90
17414914
Spine (Phila Pa 1976). 2001 Apr 15;26(8):889-96
11317111
J Bone Joint Surg Br. 2005 Aug;87(8):1029-37
16049234
Eng Med. 1984 Jul;13(3):111-4
6542880
Spine (Phila Pa 1976). 2007 May 15;32(11):1155-62; discussion 1163
17495770
Spine (Phila Pa 1976). 2000 May 1;25(9):1077-84
10788851
Spine (Phila Pa 1976). 1996 Apr 15;21(8):995-1000
8726204
Spine (Phila Pa 1976). 1988 Oct;13(10):1082-6
3206263
Spine (Phila Pa 1976). 2005 Oct 1;30(19):2192-9
16205346
Spine (Phila Pa 1976). 1987 May;12(4):362-7
3616751
Spine (Phila Pa 1976). 2001 Mar 15;26(6):E122-9
11246394
Spine (Phila Pa 1976). 1992 Mar;17(3):299-306
1566168