Skip to main content
SpringerLink
Log in

Non-fusion technology in degenerative lumbar spinal disorders: facts, questions, challenges

  • Conference paper
Arthroplasty of the Spine

  • 190 Accesses

Abstract

Although surgical fusion of the painful degenerating functional spinal unit (FSU) of the lumbar spine has always been a matter of debate, it has become a gold-standard procedure for all cases that lack an alternative treatment. However, a detailed and honest review of the clinical data reveals a considerable number of undesired side effects, complications and poor outcomes. The continuous search for alternative surgical treatment modalities has led to the development of numerous ideas for surgical reconstruction of the anterior and/or posterior column. The term “spine arthroplasty” summarises all procedures that have the goal of restoring function. This article describes the principles of the most current surgical techniques and implants, it points out potential challenges and poses a number of questions that need evidence-based answers before the incorporation of these innovations into surgical routine can be justified.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bertagnoli R, Schönmayr R, Vazquez R J (2002) Surgical and clinical results with the PDN prosthetic disc-nucleus device. Eur Spine J DOI 10.1007/s00586-002-0424-8

    Google Scholar 

  2. Brittberg M, Tallheden T, Sjögren-Jannson E, Lindahl A, Peterson L (2001) Autologous chondrocytes used for articular cartilage repair. Clin Orthop 391[Suppl]:337–348

    Google Scholar 

  3. Caserta S et al (2002) Elastic stabilisation alone or combined with rigid fusion in spinal surgery. Eur Spine J DOI 10.1007/s00586-002-0426-6

    Google Scholar 

  4. Charnley J (1974) Total hip replacement. JAMA 230:1025–1028

    Article  PubMed  CAS  Google Scholar 

  5. Danish Institute for Health Technology Assessment (1999) Low-back-pain-frequency, management and prevention from an HTA perspective. Danish Institute for Health Technology Assessment series, vol 1(1)

    Google Scholar 

  6. David T (1993) Lumbar disc prosthesis — surgical technique, indications and clinical results in 22 patients with a minimum of 12 months follow-up. Eur Spine J 1:254–259

    Article  PubMed  CAS  Google Scholar 

  7. Deyo RA (1998) Low-back pain. Sci Am 279:28–33

    Article  Google Scholar 

  8. Dubois G, de Germay B, Schaerer N, Fennema P (1999) Dynamic neutralization: a new concept for restabilization of the spine. In: Szpalski M, Gunzburg R, Pope MH (eds) Lumbar segmental instability. Lippincott Williams & Wilkins, Philadelphia, pp 233–240

    Google Scholar 

  9. Eysel P, Rompe JD, Schönmayr R, Zoellner J (1999) Biomechanical behaviour of a prosthetic lumbar nucleus. Acta Neurochir (Wien) 141:1083–1087

    Article  CAS  Google Scholar 

  10. Faciszewski T, Winter RB, Lonstein JE, et al (1995) The surgical and medical perioperative complications of anterior spinal fusion surgery in the thoracic and lumbar spine in adults. A review of 1223 procedures. Spine 20: 1592–1599

    Article  PubMed  CAS  Google Scholar 

  11. Ganey TM, Meisel H-J (2002) A potential role for cell-based therapeutics in the treatment of intervertebral disc herniation. Eur Spine J DOI 10.1007/s00586-002-0494-7

    Google Scholar 

  12. Gardner A, Pande K (2002) Graf ligamentoplasty: a 7-year follow-up. Eur Spine J DOI 10.1007/s00586-002-0436-4

    Google Scholar 

  13. Greenough CG, Taylor LJ, Fraser RD (1994) Anterior lumbar fusion: results, assessment techniques and prognostic factors. Eur Spine J 3:225–230

    Article  PubMed  CAS  Google Scholar 

  14. Greenough CG, Peterson MD, Hadlow S, Fraser RD (1998) Instrumented posterolateral lumbar fusion. Spine 23: 479–486

    Article  PubMed  CAS  Google Scholar 

  15. Griffith SL, Shelokov AP, Büttner-Janz K, Lemaire JP, Zeegers S (1994) A multicenter retrospective study of the clinical results of the LINK™ — SB Charité Intervertebral Prothesis. Spine 19:1842–1849

    Article  PubMed  CAS  Google Scholar 

  16. Husson, JL, Schärer N, Le Nihouannen JC, Freudiger S, Baumgartner W, Polard JL (1997) Nucleoplasty during discectomy: concept and experimental study. Rachis 9:145–152

    Google Scholar 

  17. Ito S, Yamada Y, Tsuboi S (1990) An observation of ruptured annulus fibrosis in lumbar discs. J Spinal Disord 4: 462–466

    Article  Google Scholar 

  18. Korge A, Nydegger Th, Polard JL, Mayer HM, Husson JL (2002) A spiral implant as nucleus prosthesis in the lumbar spine. Eur Spine J DOI 10.1007/s00586-002-0444-4

    Google Scholar 

  19. Kozak JA, Heilman AE, O’Brien JP (1994) Anterior lumbar fusion options. Clin Orthop 300:45–51

    PubMed  Google Scholar 

  20. Larsen JM, Rimoldi RL, Capen DA, et al (1996) Assessment of pseudoarthrosis in pedicle screw fusion: a prospective study comparing plain radiographs, CT scanning, and bone scintigraphy with operative findings. J Spinal Disord 9:117–120

    Article  PubMed  CAS  Google Scholar 

  21. Lemaire JP, Skalli W, Lavaste F, Templier A, Mendes F, Diop A, Sauty V, Laloux E (1997) Intervertebral disc prosthesis — results and prospects for the year 2000. Clin Orthop 337:64–76

    Article  PubMed  Google Scholar 

  22. Letcher F, Goldring S (1968) The effect of radiofrequency current and heat on peripheral nerve action potential in the cat. J Neurosurg 29:42–47

    Article  PubMed  CAS  Google Scholar 

  23. Mayer HM (1997) A new microsurgical technique for minimally invasive anterior lumbar interbody fusion. Spine 22:691–700

    Article  PubMed  CAS  Google Scholar 

  24. Mayer HM (1998) Microsurgical anterior approaches for anterior interbody fusion of the lumbar spine. In: McCulloch JA, Young PH (eds) Essentials of spinal microsurgery. Lippincott-Raven, Philadelphia, pp 633–649

    Google Scholar 

  25. Mayer HM, Wiechert K, Korge A, Qose I (2002) Minimally invasive total disc replacement — surgical technique and preliminary clinical results. Eur Spine J DOI 10.1007/s00586-002-0446-2

    Google Scholar 

  26. Modic MT, Steinberg PM, Ross JS, et al (1988) Degenerative disc disease: assessment of changes in vertebral body marrow with MR imaging. Radiology 166:193–199

    PubMed  CAS  Google Scholar 

  27. Peterson L, Minas T, Brittberg M, Nilsson A, Sjögren-Jannson E, Lindahl A (2000) Two-to-9-year outcome after autologous chondrocyte transplantation of the knee. Clin Orthop 374:212–234

    Article  PubMed  Google Scholar 

  28. Prolo DJ, Oklund SA, Butcher M (1986) Toward uniformity in evaluating results of lumbar spine operations. A paradigm applied to posterior lumbar interbody fusions. Spine 11:601–606

    Article  PubMed  CAS  Google Scholar 

  29. Ray CD (1992) The artificial disc — introduction, history and socioeconomics. In: Weinstein JN (ed) Clinical efficacy and outcome in the diagnosis and treatment of low back pain. Raven, New York, pp 205–225

    Google Scholar 

  30. Ray CD (2002) The PDN prosthetic disc-nucleus device. Eur Spine J DOI 10.1007/s00586-002-0425-7

    Google Scholar 

  31. Ray CD, Schönmayr R, Kavangh SA, Assell R (1999) Prosthetic disc nucleus implants. Riv Neuroradiol 12[Suppl]: 157–162

    Google Scholar 

  32. Saal JA, Saal JS (1998) Thermal characteristics of lumbar disc: evaluation of a novel approach to targeted intradiscal thermal therapy. Presented at the 13th Annual Meeting of the North American Spine Society. San Francisco, 28–31 October

    Google Scholar 

  33. Saal JS, Saal JA (2000) Management of chronic discogenic low back pain with a thermal intradiscal catheter. Spine 25:382–388

    Article  PubMed  CAS  Google Scholar 

  34. Schönmayr R, Busch C, Lotz C, Lotz-Metz G (1999) Prosthetic disc nucleus implants: the Wiesbaden feasibility study, 2 years follow-up in ten patients. Riv Neuroradiol 12[Suppl 1]:163–170

    Google Scholar 

  35. Sénégas J (2002) Mechanical supplementation by non-rigid fixation in degenerative intervertebral lumbar segments (the Wallis system). Eur Spine J DOI 10.1007/s00586-002-0423-9

    Google Scholar 

  36. Spivak JM, Neuwirth MG, Giordano CP, et al (1994) The perioperative course of combined anterior and posterior spinal fusion. Spine 19:520–525

    Article  PubMed  CAS  Google Scholar 

  37. Stoll TM, Dubois G, Schwarzenbach O (2002) Dynamic neutralisation system for the spine — a non-fusion system. Eur Spine J DOI 10.1007/s00586-002-0438-2

    Google Scholar 

  38. Szpalski M, Gunzburg R, Mayer HM (2002) Spine arthroplasty: a historical review. Eur Spine J DOI 10.1007/s00586-002-0474-y

    Google Scholar 

  39. Viscogliosi AG, Viscogliosi MR, Viscogliosi JJ (2000) Artificial disc — market potential and technology update. Spine Industry Analysis Series, Viscogliosi Bros. LLC, New York

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Spine Center, Orthopedic Clinic Munich-Harlaching, Harlachinger Strasse 51, 81547, Munich, Germany

    H. Michael Mayer & Andreas Korge

Authors
  1. H. Michael Mayer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andreas Korge
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H. Michael Mayer .

Editor information

Editors and Affiliations

  1. Eeuwfeestkliniek, Harmoniestraat 68, 2018, Antwerp, Belgium

    Robert Gunzburg

  2. Orthopädische Klinik, München-Harlaching Wirbelsäulenzentrum, Harlachinger Str. 51, 81243, München, Germany

    Heinz Michael Mayer

  3. Centre Hospitalier Molière Longchamps, Rue Marconi 142, 1180, Brussels, Belgium

    Marek Szpalski

  4. Maurice E. Müller Institute for Evaluative Research and Documentation in Orthopaedic Surgery, Murtenstr. 35, 3008, Bern, Switzerland

    Max Aebi

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Mayer, H.M., Korge, A. (2004). Non-fusion technology in degenerative lumbar spinal disorders: facts, questions, challenges. In: Gunzburg, R., Mayer, H.M., Szpalski, M., Aebi, M. (eds) Arthroplasty of the Spine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18508-3_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-18508-3_3

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-20295-0

  • Online ISBN: 978-3-642-18508-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation