From:
PubMed. Eur Spine J. 2006 Feb;15(2):183-95. Epub 2005 Oct 28.
Charité total disc replacement--clinical and radiographical results after an average follow-up of 17 years
Putzier M, Funk JF, Schneider SV, Gross C, Tohtz SW, Khodadadyan-Klostermann C, Perka C, Kandziora F
Abstract
A retrospective clinical-radiological study to evaluate the long-term outcome after artificial disc replacement was performed. The objective is to investigate long-term results after implantation of a modular type artificial disc prosthesis in patients with degenerative disc disease (DDD). Total disc replacement (TDR) is a surgical procedure intended to save segmental spinal function, and thus replace spondylodesis. Short-term results are promising, whereas long-term results are scarce. The Charite TDR is the oldest existing implant, therefore, the longest possible follow-up is presented here. Seventy-one patients were treated with 84 Charite TDRs types I-III. Indication for TDR was moderate to severe DDD. Fifty-three patients (63 TDRs) were available for long-term follow-up of 17 years. Evaluation included Oswestry disability index, visual analog scale, overall outcome score, plain and extension/flexion radiographs. Implantation of Charite TDR resulted in a 60% rate of spontaneous ankylosis after 17 years. No significant difference between the three types of prostheses was found concerning clinical outcome. Reoperation was necessary in 11% of patients. Although no adjacent segment degeneration was observed in the functional implants (17%), these patients were significantly less satisfied than those with spontaneous ankylosis. TDR, nowadays, is an approved procedure. Proof that long-term results of TDR implantation in DDD are at least as good as fusion results is still missing.
Keywords: artificial disc replacement; degenerative disc disease; lumbar spine; LOW-BACK-PAIN; ARTIFICIAL DISC; LUMBAR FUSION; PRODISC-II; ADJACENT; DEGENERATION; INSTABILITY; PROSTHESIS; INSTRUMENTATION; ARTHROPLASTY