Consequences of Athletic Activity in the Lumbar and Cervical Total Disc Replacement

[Justin]

The Spine Journal
Volume 7, Issue 5, Supplement 1, September-October 2007, Page 99S
Proceedings of the 22nd Annual Meeting of the North American Spine Society

Consequences of Athletic Activity in the Lumbar and Cervical Total Disc Replacement Patient: A Multi-center Non-randomized Prospective Study

James Yue MD1, Matthew Scott-Young MD2, Rudolf Bertganoli MD, PhD3, Jorge Jaramillo4, Matthew McRae MD5 and Mark McRae MD5

1Yale University, New Haven, CT, USA
2Southport, Queensland, Australia
3St. Elizabeth Klinikum, Straubing, Germany
4Yale University School of Medicine, New Haven, CT, USA
5New Haven, CT, USA

BACKGROUND CONTEXT: The influence of athletic activity on the clinical and radiographic outcomes of lumbar disc arthroplasty has not been evaluated to the best of our knowledge.

PURPOSE: To evaluate the consequences of differing levels of athletic activity on the clinical and radiographic outcomes of lumbar and cervical disc arthroplasty.

STUDY DESIGN/SETTING: Prospective, non randomized, longitudinal, multi-center, minimum 2 year follow-up.

PATIENT SAMPLE: Patients of 3 major arthroplasty centers in 3 continents (North America, Europe, and Australia).

OUTCOME MEASURES: Oswestry, VAS, Radiographic imaging.

METHODS: The prospective records of 3 major arthroplasty centers in 3 continents (North America, Europe, and Australia) were analyzed for the pre-operative and post-operative athletic activities of lumbar and cervical total disc replacement (TDR) patients. Athletic activities prior to the onset of spinal injury, after the onset of spinal injury, and post-TDR surgery were assessed. Activities were classified professional vs. amateur as well as into contact/vigorous, moderate, and light in terms of effect on involved spinal segments. Complications were assessed both radiographically as well as clinically.

RESULTS: Lumbar: A total of 1003 lumbar patients full-filled all follow-up criteria including 2 year follow-up. There were 255 Charité and 748 Prodisc prostheses. Of the Charité discs 56 participated in sports prior to spine injury. Following TDR, 48/56 participated in athletic activities (22 contact/vigorous, 11 moderate, and 15 light). Five were professional and 43 were amateur. There were no implant complications. Five patients complained of radiculopathy symptoms during participation. No implant related complications occurred during any type of activity. Of the Prodisc cases 172 participated in sports prior to spine injury. Following TDR, 158/172 participated in athletic activities (34 contact/vigorous, 27 moderate, and 97 light). Eight were professional and 150 were amateur. Seven patients complained of radiculopathy symptoms during participation. Three L5/S1 subluxations occurred with heavy weight lifting and 1 implant loosening occurred after a bike injury. Cervical: A total of 210 cervical patients full-filled all follow-up criteria including 2 year follow-up. There were 45 PCM discs and 167 Prodiscs. Of the PCM discs 18 participated in sports prior to spine injury. Following TDR, 8/18 participated in athletic activities (3 contact/vigorous, 5 moderate, and 0 light). Three were professional and 5 were amateur. There were no implant complications. No implant related complications occurred during any type of activity. Of the Prodisc cases 138 participated in sports prior to spine injury. Following TDR, 87/138 participated in athletic activities (16 contact/vigorous, 47 moderate, and 24 light). None were professional. No implant complications occurred.

CONCLUSIONS: Athletic activities of varying degrees appear to be well tolerated following both cervical and lumbar TDR surgery in single and multi-level cases. Contact-vigorous athletic activities do not appear to result in high levels of clinical or radiographic complications in the lumbar TDR patients except for heavy weight lifting activities in patients who have undergone L5/S1 Prodisc surgery in which we experienced 3 PE subluxations. In our limited number of cervical TDR patients who were involved with contact-vigorous activities, no implant complications occurred in either implant type.

FDA DEVICE/DRUG STATUS: Prodisc: Approved for this indication; Charité: Approved for this indication; PCM cervical ADR: Investigational/ Not approved.

Copyright © 2007 Elsevier Inc. All rights reserved.

[Gil Denis]

Dr J

Thanks for all this information,I would not trust most Dr. but your to be trusted
Does this mean I may ski after ADR, Fusion?

Thank You

Gil

[mmglobal]

Gil, it'll be up to you... I skied black diamonds 4 months post-op.

Don't tell Paulette that you can ski... we need a sandbagger. So far, she's kicked everone's ass.

You can ingore all the pre-trip blustering...

First annual spiney / ADR ski reunion!

[Gil Denis]

Hi Mark

Let me know when I`ll be their

I skied Sunday on green runs and feel O.K. today

Talk soon

Thanks Gil

[Justin]

Gil, that sounds awesome!

I miss the snow SOOOO much. I used to be on the National Ski Patrol, but I have yet to set foot on another run since my ADR surgery in 2003.

Mark: if there is another ski trip planned in the future, you'll have to kidnap me and throw some boots and skis on my feet.

[Terry Allen Blackburn]

I have been hesitant to return to skiing but, with reassurance here, I will be back on the boards.

I do walk, garden, snowshoe, and bicycle. I rode 2,354 the season I was healing from my 4 level ADR and I rode 2,100 miles this past riding season.

I think that, those who were athletic pre-surgery, will do better in the healing phase of their recovery as well. This is due to being loosened up before the surgery, having the endorphin release from aerobic conditioning, strength training for pre-surgical conditioning.

Thanks for the nice report Justin.

Terry Newton

[mmglobal]

Regarding my spiney ski trips... I'm a 1.5 years into torn miniscus, L knee... avoiding surgery, but can't put any torque. R knee broken down and painful too. I was trying to plan another one for early 2008... but the knees made it impossible. I'd really like to hit the slopes, but have no idea when I'll be in good enough shape. Getting old sucks.

Mark

[Gil Denis]

Hi Mark
It`s better than the other alternative.
Miniscus is a simple operation, they would just remove the tear.
Right knee take a skiers m+m.Advil
Hitting the slopes hurts,Look ahead, go fast, dont fall down.

I will ski again on Sunday to watch my son race.
Lets do a spiney ski trip in 2010?

ski you later
Gil

[ans]

Mark: I had for one knee the lateral and interior meniscii taken care of by arthroscopy. Two days later I was walking OK w/a cane and to date (it was in '86) there's no problem. Had another meniscus tear taken care of in the '70s the old way (no arthroscopy then) and came down with chondromalacia. I guess I'm saying is that it might be worth going for it. Dr. J. would know if you're harming your knee by postponing surgery. One thing for sure: if you've had your knee lock up, the pain's utterly excruciating. Best - Allan

[racergaldar]

Man oh man! I would give anything to be in the slopes right now. Please someone give me some hope that skiing or GS racing will not be a faded memory.

[ans]

I was no ski stud but I've had successive dreams on how fun it is to ski. Loved it, indescribable feeling.

[Terry Allen Blackburn]

I have it lined up to downhill ski, for the first time since my ADR Surgery over two years ago, this coming Wednesday, for a little night skiing. We have had about 116" of snow so far and more on the way.

I am going to behave.

Anyone who knows me knows that I just told a fib. LOL

Terry Newton

[Kathy]

I wish I could ski, I didn't even master the bunny hill. First time up the bunny hill lift, I did something wrong, fell on my a**; but not before hitting my head on the lift. Gave up on skiing after 2 hours. 2 hours later decide to 'get back on the horse and ride again'. Do the bunny hill successfully, get brave and go up the real lift. Proceed to do the green, after much more busting of my rear, 45 minutes and very little area covered... I crawl (not walk; but crawl) to the side of the mountain and cry (yes big person crying on side of mountain as little children fly by me). I beg my family to get me a ride on a snow mobile down, loving family declines. I then slowly manuever myself down the steeper part of the incline. Get up and began going extremely fast, at this point I know I am about to die. I see lots of trees coming fastly, can't stop, not sure how to turn, can't fall down because I'm sure something will break; so I know I'm gonna hit a tree like Sunny did and be dead. Somehow, not by my own skiing ability, I get to the bottom. It is one of the happiest moments of my life, I am alive. I remove ski gear and decide making snow angels is good enough for me!

[Gil Denis]

Hi Terry
Going skiing.
Take it slow and easy, try to get your legs back. Snow plow to get quad strength.
When you feel balanced and strong let it rip on groomers,no bumps.
Look ahead go fast don`t fall down
Clear glasses or goggles works best for night skiing.
Have a great time.
Gil
I skied on Saturday now I am stiff and crooked

[New-disc]

Terry,

Enjoy the fresh air, please don't over due things... it's in our blood to push it.

Thats just who we are.... we love to compete against our iner-self.

Be good!

Please keep us all posted.... ( pictures? )

Todd

[New-disc]

Hello,

I needed to cancel my Snow-shoe Mountian trip today (due to a painful hip problem.)

Almost 7yrs of limping around waiting for surgery must of weakend the socket.

The joys of getting old......

X-rays next week.....

Will our/the new USA health care system want to fix me?

I'll keep ya posted.

Todd

[trkdoc714]

Good luck on the Xrays Todd. I hope it's a minor problem and easy fix.

Welcome to geezerhood!

Bob

[Gil Denis]

Hi Todd
Sorry to hear about your hip I have friends that have had Total Hip Replacement both sides and now ski over 100 days a season with no problems.
their are in their 60`s.
"Living in a dry climate is easier on your joints".
Getting old is a wicked good thing better than a dirt nap
We know hip replacement works ADR
Take Care
Missing Maine
Gil Denis

[Terry Allen Blackburn]

Todd:

I am so sorry that something is standing in the way again of you enjoying life to the fullest. May you grab this by the horn like you did your spine and get back to it.

Life is not a spectator sport.

Terry Newton

[New-disc]

Hello,

Thanks for the support!!

I'll be sure to keep a public record of my health.

Todd

[Firerescuefin]

Justin,

Thanks for posting the study. That was one that I definitely wanted to see. Have you made any headway with regard to your recent setback and new symptoms.

Geoff

[New-disc]

Hello,

I was able to get out into the fresh Mt. air the other
day.

Enjoyed a short walk on snow-shoes .....

X-ray of my Maverick disc looks ok .....

(1yr, and a half after surgery)

Still having some hip joint pain .. needs to be looked into deeper.

Todd

[New-disc]

Hello,

Lets pray for Lance Armstrong!!

"he was involved in a bike crash".

Todd

[Gil Denis]

Hi Todd

Just heard Lance broke his collar bone should be back in action in six weeks.

How the weather in Maine? Snowing here

take care

Gil

[New-disc]

Gil,

Lots of snow still on the ground up here in Maine.

Wow! looks like ya getting a wicked spring storm!

T-shirt Mt. sports!!

If ya get bored.... please send pictures of your past adventures!


jeep_travels@yahoo.com