Measurement Error of Lumbar Total Disc Replacement Range of Motion

Lim, Moe R.; Loder, Randall T.; Huang, Russel C.; Lyman, Stephen; Zhang, Kai; Sama, Andrew A.; Papadopoulos, E.; Warner, Kristin K.; Girardi, Federico P.; Cammisa, Frank P.

doi:10.1097/01.brs.0000216452.54421.ea

Cited by 55 publications

(32 citation statements)

References 15 publications

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“…Conversely, the spikes of the upper and lower prosthesis-keels were used as radiological landmarks to determine the postoperative segmental ROM. This method has been described and recommended in previous studies due to improved precision and inter/intraobserver reliability [8,38,39].…”

Section: Study Protocol and Patient Selectionmentioning

confidence: 99%

Total lumbar disc replacement in athletes: clinical results, return to sport and athletic performance

Siepe¹,

Wiechert²,

Khattab

et al. 2007

Eur Spine J

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Despite the increasing popularity of total lumbar disc replacement (TDR) in predominantly young and active patients, no previous study has addressed possibilities, limitations and potential risks regarding athletic performance following TDR. Mechanical concerns remain and the implant's resilience as regards its load-bearing capacity during sporting activities is unknown. Thirty-nine athletic patients fulfilled the inclusion criteria for this study. These patients participated in a large variety of different types of sport. Significant and lasting pain-relief was attained following TDR with a mean follow-up of 26.3 months (range 9-50.7 months; FU rate 97.4%). Sporting activity was resumed within the first 3 months (38.5%) to 6 months (30.7%) with peak performance being reached after 5.2 months. Thirty-seven patients (94.9%) achieved resumption of sporting activity. Athletic performance improved significantly in 33 patients (84.6%). Minor subsidence was observed in 13 patients (30%) within the first 3 months with no further implant migration thereafter in 12 patients. Participation in all types of sport recorded in this study was accessible for a high rate of patients up to the level of professional athletes as well as those participating in extreme sports. Preoperative participation in sport proved to be a strong positive predictor for highly satisfactory postoperative outcome following TDR. In a selected group of patients, however, preoperative inability to participate in sporting activities did not impair postoperative physical activity. Due to the young age of the patients and significant load increase exerted during athletic activities, persisting concerns regarding the future behaviour of the implant remain and will require longer follow-up, modified investigation techniques and larger patient cohorts.

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Section: Study Protocol and Patient Selectionmentioning

confidence: 99%

Total lumbar disc replacement in athletes: clinical results, return to sport and athletic performance

Siepe¹,

Wiechert²,

Khattab

et al. 2007

Eur Spine J

View full text Add to dashboard Cite

show abstract

“…Using a high accuracy computational based approach however, produces a lower end in the measurement error as compared to what can be expected in everyday clinical practice. Thus even the 4.6°threshold previously reported for the occurrence of motion may indeed be low [15].…”

Section: Discussionmentioning

confidence: 69%

“…Other studies however continue to report TDR flexion-extension ROM values even below this suggested 2°threshold [13,17]. A recent study suggests that a threshold angle of at least 4.6°between flexion-extension radiographs must be measured before one can be certain that the ROM of the TDR is not 0 [15]. Furthermore, previous findings using the same motionless (by protocol, not by design) TDR as in the present study, have shown that variations in patient placement (rotation and elevation at the level of the arthroplasty) with respect to the radiographic beam source may lead to angle measurement inaccuracies and misinterpretations concerning TDR motion [10].…”

Section: Discussionmentioning

confidence: 97%

“…TDR motion greater than 5°has been suggested to reduce the incidence of adjacent level degeneration [6][7][8]. Previous studies report on observer agreement statistics in TDR ROM measurements which tell us only about measurement precision [1,14,15]. This study aims to report on TDR angle measurement accuracy, analyzing both precision and bias errors, of the commonly used Oxford Cobbometer.…”

Section: Discussionmentioning

confidence: 99%

“…Small amounts of TDR motion may considerably influence clinical outcome [6][7][8]15]. TDR motion greater than 5°has been suggested to reduce the incidence of adjacent level degeneration [6][7][8].…”

Section: Discussionmentioning

confidence: 99%

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Radiographic total disc replacement angle measurement accuracy using the Oxford Cobbometer: precision and bias

et al. 2008

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Total disc replacement (TDR) clinical success has been reported to be related to the residual motion of the operated level. Thus, accurate measurement of TDR range of motion (ROM) is of utmost importance. One commonly used tool in measuring ROM is the Oxford Cobbometer. Little is known however on its accuracy (precision and bias) in measuring TDR angles. The aim of this study was to assess the ability of the Cobbometer to accurately measure radiographic TDR angles. An anatomically accurate synthetic L4-L5 motion segment was instrumented with a CHARITE artificial disc. The TDR angle and anatomical position between L4 and L5 was fixed to prohibit motion while the motion segment was radiographically imaged in various degrees of rotation and elevation, representing a sample of possible patient placement positions. An experienced observer made ten readings of the TDR angle using the Cobbometer at each different position. The Cobbometer readings were analyzed to determine measurement accuracy at each position. Furthermore, analysis of variance was used to study rotation and elevation of the motion segment as treatment factors. Cobbometer TDR angle measurements were most accurate (highest precision and lowest bias) at the centered position (95.5%), which placed the TDR directly inline with the x-ray beam source without any rotation. In contrast, the lowest accuracy (75.2%) was observed in the most rotated and off-centered view. A difference as high as 4°between readings at any individual position, and as high as 6°between all the positions was observed. Furthermore, the Cobbometer was unable to detect the expected trend in TDR angle projection with changing position. Although the Cobbometer has been reported to be reliable in different clinical applications, it lacks the needed accuracy to measure TDR angles and ROM. More accurate ROM measurement methods need to be developed to help surgeons and researchers assess radiological success of TDRs.

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Anschlusssegmentbeweglichkeit nach monosegmentaler Bandscheibenprothesenimplantation und monosegmentaler Fusion Segment L4/5

et al. 2013

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Measurement Error of Lumbar Total Disc Replacement Range of Motion

Cited by 55 publications

References 15 publications

Total lumbar disc replacement in athletes: clinical results, return to sport and athletic performance

Total lumbar disc replacement in athletes: clinical results, return to sport and athletic performance

Radiographic total disc replacement angle measurement accuracy using the Oxford Cobbometer: precision and bias

Anschlusssegmentbeweglichkeit nach monosegmentaler Bandscheibenprothesenimplantation und monosegmentaler Fusion Segment L4/5

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