Lumbar intervertebral disc allograft transplantation: long-term mobility and impact on the adjacent segments
- 393 Downloads
Fresh-frozen intervertebral disc (IVD) allograft transplantation has been successfully performed in the human cervical spine. Whether this non-fusion technology could truly decrease adjacent segment disease is still unknown. This study evaluated the long-term mobility of the IVD-transplanted segment and the impact on the adjacent spinal segments in a goat model.
Twelve goats were used. IVD allograft transplantation was performed at lumbar L4/L5 in 5 goats; the other 7 goats were used as the untreated control (5) and for the supply of allografts (2). Post-operation lateral radiographs of the lumbar spine in the neutral, full-flexion and full-extension positions were taken at 1, 3, 6, 9 and 12 months. Disc height (DH) of the allograft and the adjacent levels was calculated and range of motion (ROM) was measured using the Cobb’s method. The anatomy of the adjacent discs was observed histologically.
DH of the transplanted segment was decreased significantly after 3 months but no further reduction was recorded until the final follow-up. No obvious alteration was seen in the ROM of the transplanted segment at different time points with the ROM at 12 months being comparable to that of the untreated control. The DH and ROM in the adjacent segments were well maintained during the whole observation period. At post-operative 12 months, the ROM of the adjacent levels was similar to that of the untreated control and the anatomical morphology was well preserved.
Lumbar IVD allograft transplantation in goats could restore the segmental mobility and did not negatively affect the adjacent segments after 12 months.
KeywordsIntervertebral disc Allograft Transplantation Mobility Adjacent segments
Compliance with ethical standards
Conflict of interest
- 7.Harrop JS, Youssef JA, Maltenfort M, Vorwald P, Jabbour P, Bono CM, Goldfarb N, Vaccaro AR, Hilibrand AS (2008) Lumbar adjacent segment degeneration and disease after arthrodesis and total disc arthroplasty. Spine (Phila Pa 1976) 33:1701–1707. doi: 10.1097/BRS.0b013e31817bb956 CrossRefGoogle Scholar
- 10.Burkus JK, Traynelis VC, Haid RW Jr, Mummaneni PV (2014) Clinical and radiographic analysis of an artificial cervical disc: 7-year follow-up from the Prestige prospective randomized controlled clinical trial: clinical article. J Neurosurg Spine 21:516–528. doi: 10.3171/2014.6.SPINE13996 CrossRefPubMedGoogle Scholar
- 15.An HS, Takegami K, Kamada H, Nguyen CM, Thonar EJ, Singh K, Andersson GB, Masuda K (2005) Intradiscal administration of osteogenic protein-1 increases intervertebral disc height and proteoglycan content in the nucleus pulposus in normal adolescent rabbits. Spine (Phila Pa 1976) 30:25–31. doi: 10.1097/01.brs.0000148002.68656.4d
- 23.Luo J, Gong M, Huang S, Yu T, Zou X (2015) Incidence of adjacent segment degeneration in cervical disc arthroplasty versus anterior cervical decompression and fusion meta-analysis of prospective studies. Arch Orthop Trauma Surg 135:155–160. doi: 10.1007/s00402-014-2125-2 CrossRefPubMedGoogle Scholar
- 27.Reitmaier S, Schmidt H, Ihler R, Kocak T, Graf N, Ignatius A, Wilke HJ (2013) Preliminary investigations on intradiscal pressures during daily activities: an in vivo study using the merino sheep. PLoS One 8:e69610. doi: 10.1371/journal.pone.0069610PONE-D-13-09319 CrossRefPubMedPubMedCentralGoogle Scholar