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

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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.