The innovative viscoelastic CP ESP cervical disk prosthesis with six degrees of freedom: biomechanical concepts, development program and preliminary clinical experience.
The viscoelastic cervical disk prosthesis ESP is an innovative one-piece deformable but cohesive interbody spacer. It is an evolution of the LP ESP lumbar disk implanted since 2006. CP ESP provides six full degrees of freedom about the three axes including shock absorbtion. The prosthesis geometry allows limited rotation and translation with resistance to motion (elastic return property) aimed at avoiding overload of the posterior facets. The rotation center can vary freely during motion. The concept of the ESP prosthesis is fundamentally different from that of the devices currently used in the cervical spine. The originality of the concept of the ESP® prosthesis led to innovative and intense testing to validate the adhesion of the viscoelastic component of the disk on the titanium endplates and to assess the mechanical properties of the PCU cushion. The preliminary clinical and radiological results with 2-year follow-up are encouraging for pain, function and kinematic behavior (range of motion and evolution of the mean centers of rotation). In this series, we did not observe device-related specific complications, misalignment, instability or ossifications. Additional studies and longer patient follow-up are needed to assess long-term reliability of this innovative implant.
Pitié Salpétrière Hospital, UPMC, Paris, France. lazennec.jy@wanadoo.fr.
Jean-Yves
JY
Lazennec
FHI, Quimper, France.
Alain
A
Aaron
Kirchberg Hospital, Luxembourg, Luxembourg.
Olivier
O
Ricart
Clinique du Pré, Le Mans, France.
Jean Patrick
JP
Rakover
D000328:Adult; D001672:Biocompatible Materials; D001696:Biomechanical Phenomena / Q000502:physiology; D002574:Cervical Vertebrae / Q000502:physiology / Q000601:surgery*; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000503:physiopathology / Q000517:prevention & control / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000503:physiopathology / Q000517:prevention & control; D011446:Prospective Studies; D019736:Prostheses and Implants; D011474:Prosthesis Design; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology; D013123:Spinal Fusion / Q000295:instrumentation*; D016896:Treatment Outcome
D001672:Biocompatible Materials
Artificial disk; CP ESP; Cervical disk prosthesis; Cervical spine mobility; Degenerative cervical disk; Rotation center; Viscoelastic disk replacement