European Spine Journal

, Volume 14, Issue 5, pp 507–511 | Cite as

Revision of a Charité artificial disc 9.5 years in vivo to a new Charité artificial disc: case report and explant analysis

  • Thierry DavidEmail author
Case Report


This report describes a case of one-level total disc replacement (TDR) of L5-S1 requiring revision at 9.5 years following the index surgery due to polyethylene failure caused by high oxidation. Primary revision strategies for TDR include instrumented posterolateral fusion, or 360° fusion with replacement of the prosthesis with cages or allograft bone. A revision of a TDR with a similar prosthesis has not been described in the literature. An active 42-year-old female underwent TDR with a Charité artificial disc. She remained active and pain free for 9.5 years before presenting with moderate low-back pain and sciatica. Radiographic studies confirmed a fragmented polyethylene core. The failed prosthesis was revised to a new Charité disc with the patient again active and pain free for 6 months following surgery. Chemical and physical analysis of the core indicated high oxidation due to gamma sterilization in air; a process changed to gamma sterilization in nitrogen in 1998 to meet industry standards. No evidence of wear debris was noted. Revision of an artificial disc with an artificial disc can be performed safely and adequately with the Charité disc prosthesis as an alternative to fusion necessitated by a device failure. An anterior revision approach carries significant risk and should only be performed by surgeons experienced in anterior lumbar surgery.


Lumbar spine Artificial disc Revision 


  1. 1.
    Bargmann LS, Bargmann BC, Collier JP, Currier BH, Mayor MB (1999) Current sterilization and packaging methods for polyethylene. Clin Orthop 369:49–58Google Scholar
  2. 2.
    Callaghan JJ (2001) Mobile-bearing knee replacement: clinical results: a review of the literature. Clin Orthop 392:221–225Google Scholar
  3. 3.
    Cunningham BW, Godron JD, Dmitriev AE, Hu N, McAfee PC (2003) Biomechanical evaluation of total disc replacement arthroplasty: an in vitro human cadaveric model. Spine 28:S110–S117CrossRefGoogle Scholar
  4. 4.
    David T (2002) Lumbar disc prosthesis: five years follow-up study on 147 patients with 163 SB Charité prosthesis. Eur Spine J 11 (Suppl 1):S18Google Scholar
  5. 5.
    Huang RC, Girardi FP, Cammisa FP Jr, Tropiano P, Marnay T (2003) Long-term flexion-extension range of motion of the ProDisc total disc replacement. J Spinal Disord Tech 2(16):435–440CrossRefGoogle Scholar
  6. 6.
    Lemaire JP (2002) SB Charité III intervertebral disc prosthesis: biomechanical, clinical, and radiological correlations with a series of 100 cases over a follow-up of more than 10 years. Rachis 14:271–285Google Scholar
  7. 7.
    McAfee PC, Cunningham BW, Geisler FH, Regan JJ, Guyer RD, Blumenthal SL, Maxwell J (2004) A prospective randomized FDA study of the Charité disc replacement—a radiographic outcome analysis of 276 consecutive patients. Proceedings of the 31st annual meeting of the international society for the study of the lumbar spine (ISSLS), Porto, 5 June 2004Google Scholar
  8. 8.
    Marnay T (2001) Lumbar disc replacement, 7–10 years results with Prodisc. Eur Spine J 10 (Suppl 1):S67Google Scholar
  9. 9.
    van Ooij A, Oner FC, Verbout AJ (2003) Complications of artificial disc replacement. J Spinal Disord Tech 16:369–383Google Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  1. 1.Polyclinique de Bois-BernardBois-BernardFrance

Personalised recommendations