The future of spinal arthroplasty: a biomaterial perspective

Oskouian, Rod J.; Whitehill, Richard; Samii, Amir; Shaffrey, Mark E.; Johnson, J. Patrick; Shaffrey, Christopher I.

doi:10.3171/foc.2004.17.3.2

Cited by 31 publications

(12 citation statements)

References 74 publications

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“…15 The knowledge gained in the development of diarthrodial synovial joint replacements (hip and knee) has been trans- Figure 2. 15 The knowledge gained in the development of diarthrodial synovial joint replacements (hip and knee) has been trans- Figure 2.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging Clarity of the Bryan®, Prodisc-C®, Prestige LP®, and PCM® Cervical Arthroplasty Devices

Sekhon¹,

Duggal

Lynch³

et al. 2007

Spine

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Preoperative and postoperative magnetic resonance imaging scans of 20 patients who had undergone cervical arthroplasty were assessed for imaging quality. Five cases each of the Bryan (Medtronic Sofamor Danek, Memphis, TN), Prodisc-C (Synthes Spine, Paoli, PA), Prestige LP (Medtronic Sofamor Danek), and PCM devices (Cervitech, Rockaway, NJ) were analyzed. Six blinded spinal surgeons scored twice sagittal and axial T2-weighted images using the Jarvik 4-point scale. Statistical analysis was performed comparing quality before surgery and after disc implantation at the operated and adjacent levels and between implant types. RESULTS.: Moderate intraobserver and interobserver reliability was noted. Preoperative images of patients in all implant groups had high-quality images at operative and adjacent levels. The Bryan and Prestige LP devices allowed satisfactory visualization of the canal, exit foramina, cord, and adjacent levels after arthroplasty. Visualization was significantly impaired in all PCM and Prodisc-C cases at the operated level in both the spinal canal and neural foramina. At the adjacent levels, image quality was statistically poorer in the PCM and Prodisc-C than those of Prestige LP or Bryan. CONCLUSIONS.: Postoperative visualization of neural structures and adjacent levels after cervical arthroplasty is variable among current available devices. Devices containing nontitanium metals (cobalt-chrome-molybdenum alloys in the PCM and Prodisc-C) prevent accurate postoperative assessment with magnetic resonance imaging at the surgical and adjacent levels. Titanium devices, with or without polyethylene (Bryan disc or Prestige LP), allow for satisfactory monitoring of the adjacent and operated levels. This information is crucial for any surgeon who wishes to assess adequacy of neural decompression and where monitoring of adjacent levels is desired.

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Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging Clarity of the Bryan®, Prodisc-C®, Prestige LP®, and PCM® Cervical Arthroplasty Devices

Sekhon¹,

Duggal

Lynch³

et al. 2007

Spine

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“…The choice of material for a prosthesis should consider the needs of both the articulating surface and the interface between prosthesis and vertebral body. [13] Significant knowledge gained in the development of diarthodial synovial joint replacements (hip and knee) has been translated to the manufacture of arthroplasty prostheses. Articular surfaces may involve a metal-on-metal, metal on-polymer (poly), ceramic-on-poly or ceramic-on-ceramic interface.…”

Section: Methodsmentioning

confidence: 99%

Artificial cervical disc replacement: Principles, types and techniques

Sekhon

Ball

2005

Neurol India

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Cervical arthroplasty after anterior decompression with insertion of a prosthetic total disc replacement has been suggested as an alternate to anterior cervical fusion. Currently there are four cervical arthroplasty devices available on the market whose results in clinical use have been reported. Each device varies in terms of materials, range of motion, insertion technique and constraint. It is not known which device is ideal. Early studies suggest that in the short term, the complication rate and efficacy is no worse than fusion surgery. Long-term results have not yet been reported. This review examines the current prostheses available on the market as well as discussing issues regarding indications and technique. Pitfalls are discussed and early experiences reviewed. In time, it is hoped that a refinement of cervical arthroplasty occurs in terms of both materials and design as well as in terms of indications and clinical outcomes as spinal surgeons enter a new era of the management of cervical spine disease.

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“…Polymers and ceramics may also be employed in the design of future intervertebral disc prostheses. These products will provide mechanical support, motion sparing, and can be easily imaged with MRI[43] [Figure 2]. …”

Section: Motion Preservationmentioning

confidence: 99%

The future of spine surgery: New horizons in the treatment of spinal disorders

Kazemi

Crew²,

Tredway³

2013

Surg Neurol Int

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Background and Methods:As with any evolving surgical discipline, it is difficult to predict the future of the practice and science of spine surgery. In the last decade, there have been dramatic developments in both the techniques as well as the tools employed in the delivery of better outcomes to patients undergoing such surgery. In this article, we explore four specific areas in spine surgery: namely the role of minimally invasive spine surgery; motion preservation; robotic-aided surgery and neuro-navigation; and the use of biological substances to reduce the number of traditional and revision spine surgeries.Results:Minimally invasive spine surgery has flourished in the last decade with an increasing amount of surgeries being performed for a wide variety of degenerative, traumatic, and neoplastic processes. Particular progress in the development of a direct lateral approach as well as improvement of tubular retractors has been achieved. Improvements in motion preservation techniques have led to a significant number of patients achieving arthroplasty where fusion was the only option previously. Important caveats to the indications for arthroplasty are discussed. Both robotics and neuro-navigation have become further refined as tools to assist in spine surgery and have been demonstrated to increase accuracy in spinal instrumentation placement. There has much debate and refinement in the use of biologically active agents to aid and augment function in spine surgery. Biological agents targeted to the intervertebral disc space could increase function and halt degeneration in this anatomical region.Conclusions:Great improvements have been achieved in developing better techniques and tools in spine surgery. It is envisaged that progress in the four focus areas discussed will lead to better outcomes and reduced burdens on the future of both our patients and the health care system.

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The future of spinal arthroplasty: a biomaterial perspective

Cited by 31 publications

References 74 publications

Magnetic Resonance Imaging Clarity of the Bryan®, Prodisc-C®, Prestige LP®, and PCM® Cervical Arthroplasty Devices

Magnetic Resonance Imaging Clarity of the Bryan®, Prodisc-C®, Prestige LP®, and PCM® Cervical Arthroplasty Devices

Artificial cervical disc replacement: Principles, types and techniques

The future of spine surgery: New horizons in the treatment of spinal disorders

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