Mobidisc Disc Prosthesis

Steib, Jean-Paul; Aubourg, Lucie; Beaurain, Jacques; Delécrin, J.; Allain, J.; Chataigner, H.; Bogorin, Iohan; Ameil, Marc; Dufour, Thierry; Stecken, J

doi:10.1016/b978-1-4160-3994-5.10040-7

Cited by 2 publications

(3 citation statements)

References 5 publications

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“…TDRs were implanted after failed nonoperative therapy for a minimum of 6 months, 8 , 9 , 13 , 16 , 18 , 19 , 25 , 26 , 28 , 29 , 32 – 37 , 40 – 42 although nonoperative therapy duration varied from 338 to 9 months. 30 …”

Section: General Indications For Lumbar Tdrmentioning

confidence: 99%

“…Several studies included patients with prior surgery, such as microdiscectomy or percutaneous nucleotomy. 12 , 16 , 17 , 24 , 26 , 40 , 42 , 43 Others allowed patients with failed disc excision, 11 failed spine surgery, 26 prior fusion with adjacent segment disease (ASD), 12 , 41 , 44 , 45 and below a previous long fusion for scoliosis. 46 Bertagnoli et al 30 , 44 found no differences in outcomes for patients with prior posterior discectomy or laminectomy vs. those with no previous surgery for both single- and multi-level TDR.…”

Section: General Indications For Lumbar Tdrmentioning

confidence: 99%

“…TDR indications are generally back and/or leg pain with no nerve root compression 9 , 28 , 30 , 49 or back pain with/without leg pain. 13 , 16 , 29 , 34 – 36 , 38 , 40 , 42 These symptoms can be quantified using patient self-assessments. For potential TDR patients, indications have been described as preoperative VAS back pain scores of at least 40 9 , 18 , 34 , 35 , 37 or 50 38 of 100.…”

Section: General Indications For Lumbar Tdrmentioning

confidence: 99%

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Indications for Lumbar Total Disc Replacement: Selecting the Right Patient with the Right Indication for the Right Total Disc

Büttner-Janz¹,

Guyer

Ohnmeiss

2014

Int J Spine Surg

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Summary of Background DataAs with any surgery, care should be taken to determine patient selection criteria for lumbar TDR based on safety and optimizing outcome. These goals may initially be addressed by analyzing biomechanical implant function and early clinical experience, ongoing evaluation is needed to refine indications.ObjectiveThe purpose of this work was to synthesize information published on general indications for lumbar TDR. A secondary objective was to determine if indications vary for different TDR designs.MethodsA comprehensive literature search was conducted to identify lumbar TDR articles. Articles were reviewed and patient selection criteria and indications were synthesized.ResultsWith respect to safety, there was good agreement in the literature to exclude patients with osteopenia/osteoporosis or fracture. Risk of injury to vascular structures due to the anterior approach was often addressed by excluding patients with previous abdominal surgery in the area of disc pathology or increased age. The literature was very consistent on the primary indication for TDR being painful disc degeneration unresponsive to at least 6 months of nonoperative care. Literature investigating the impact of previous spine surgery was mixed; however, prior surgery was not necessarily a contra-indication, provided the patient otherwise met selection criteria. The literature was mixed on setting a minimum preoperative disc height as a selection criterion. There were no publications investigating whether some patients are better/worse candidates for specific TDR designs. Based on the literature a proposal for patient selection criteria is offered.ConclusionsSeveral TDR indications and contra-indications are widely accepted. No literature addresses particular TDR design being preferable for some patients. As with any spine surgery, ongoing evaluation of TDR outcomes will likely lead to more detailed general and device design specific indications.

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Section: General Indications For Lumbar Tdrmentioning

confidence: 99%

Section: General Indications For Lumbar Tdrmentioning

confidence: 99%

Section: General Indications For Lumbar Tdrmentioning

confidence: 99%

See 1 more Smart Citation

Indications for Lumbar Total Disc Replacement: Selecting the Right Patient with the Right Indication for the Right Total Disc

Büttner-Janz¹,

Guyer

Ohnmeiss

2014

Int J Spine Surg

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Clinical, radiological, histological and retrieval findings of Activ-L and Mobidisc total disc replacements: a study of two patients

et al. 2012

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Introduction This study evaluates the short-term clinical outcome, radiological, histological and device retrieval findings of two patients with second generation lumbar total disc replacement (TDR). Materials and methods The first patient had a single level L4-L5 Activ-L TDR, the second patient a L4-L5 Mobidisc and L5-S1 Activ-L TDR. The TDRs were implanted elsewhere and had implantation times between 1.3 and 2.8 years.Results Plain radiographs and CT-scanning showed slight subsidence of the Activ-L TDR in both patients and facet joint degeneration. The patients underwent revision surgery because of recurrent back and leg pain. After removal of the TDR and posterolateral fusion, the pain improved. Histological examination revealed large ultrahigh molecular weight polyethylene (UHMWPE) particles and giant cells in the retrieved tissue surrounding the Mobidisc. The particles in the tissue samples of the Activ-L TDR were smaller and contained in macrophages. Retrieval analysis of the UHMWPE cores revealed evidence of minor adhesive and abrasive wear with signs of impingement in both TDR designs. Conclusion Although wear was unrelated to the reason for revision, this study demonstrates the presence of UHMWPE particles and inflammatory cells in second generation TDR. Long-term follow-up after TDR is indicated for monitoring wear and implant status.

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Mobidisc Disc Prosthesis

Cited by 2 publications

References 5 publications

Indications for Lumbar Total Disc Replacement: Selecting the Right Patient with the Right Indication for the Right Total Disc

Indications for Lumbar Total Disc Replacement: Selecting the Right Patient with the Right Indication for the Right Total Disc

Clinical, radiological, histological and retrieval findings of Activ-L and Mobidisc total disc replacements: a study of two patients

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