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Total disc arthroplasty: consequences for sagittal balance and lumbar spine movement

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Abstract

This in vivo biomechanical study was undertaken to analyze the consequences for sagittal balance and lumbar spine movement in three different lumbar disc prostheses. A total of 105 patients underwent total disc replacement in three different centers. The Maverick® prosthesis was used in 46 patients, the SB Charité® device was used in 49 patients and the Prodisc® device was utilized in 10 patients. The analysis was computer assisted, using Spineview® and Matlab® softwares. The intra and inter-observer reliability and measurement uncertainty was performed. The analysis of lateral X-ray films in flexion–extension allowed to measure the prosthesis positioning, the range of motion (ROM), the localization of the mean center of rotation (MCR), the vertebral translation and the disc height, for each prosthesis device. The sagittal balance was analyzed on a full spine film. The parameters studied were described by Duval-Beaupère. The results were compared to the data found in literature, and compared to 18 asymptomatic volunteers, and 61 asymptomatic subjects, concerning the sagittal balance. The prostheses allowed an improvement of the ROM of less than 2°. The ROM of L5–S1 prostheses ranged from 11.6 to 15.6% of the total lumbar motion during flexion–extension. At L4–L5 level, the ROM decreased when there was an arthrodesis associated at the L5–S1 level. There was no difference of ROM between the three prostheses devices. The MCR was linked to the ROM, but did not depend on the prosthesis offcentering. The disc height improved for any prosthesis, and decreased in flexion or in extension, when the prosthesis was offcentered. An increase of translation indicated a minor increase of the ROM at L4–L5 level after Maverick® or SB Charité® implantation. The L5–S1 arthrodesis was linked with an increase of the pelvic tilt. The lumbar lordosis curvature increased between L4 and S1, even more when a prosthesis was placed at the L3–L4 level. Total disc arthroplasty is useful in the surgical management of discogenic spinal pathology. The three prostheses studied allowed to retorate the disc height, the ROM, without disrupting the sagittal balance, but induced modification of the lumbar curvature.

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References

  1. Bertagnoli R, Kumar S (2002) Indications for full prosthetic disc arthroplasty: a correlation of clinical outcome against a variety of indications. Eur Spine J 11:S131–S136

    PubMed  Google Scholar 

  2. Blumenthal SL, Ohnmeiss DO, Guyer RD et al (2003) Prospective study evaluating total disc replacement. Preliminary results. J Spinal Disord 16:450–454

    Article  Google Scholar 

  3. Cinotti G, David T, Postacchini F (1996) Results of disc prosthesis after a minimum follow-up period of 2 years. Spine 15:995–1000

    Article  Google Scholar 

  4. Cunningham BW, Gordon JD, Dimitriev A et al (2003) Biomechanical evaluation of total disc replacement arthroplasty: an in vitro human cadaveric model. Spine 28:S110–S117

    Article  PubMed  Google Scholar 

  5. David T (1993) Lumbar disc prosthesis. Eur Spine J 1:254–259

    Article  Google Scholar 

  6. de Kleuver M, Oner FC, Jacobs WCH (2003) Total disc replacement for chronic low back pain: background and systematic review of the literature. Eur Spine J 12:108–116

    PubMed  Google Scholar 

  7. Duval-Beaupère G, Robain G (1987) Visualization on full spine radiographs of the anatomical connections of the center of the segmental body mass supported by each vertebra and measured in vivo. Int Orthop 11:261–269

    Article  PubMed  Google Scholar 

  8. Griffith SL, Shelokov AP, Büttner-Janz K et al (1994) A multicenter retrospective study of the clinical results of the LINk SB Charité intervertebral prosthesis. Spine 19:1842–1849

    Article  PubMed  CAS  Google Scholar 

  9. Guigui P, Lambert P, Lassale B et al (1997) Evolution à long terme des niveaux adjacents à une arthrodèse lombaire. Rev Chir Orthop 83:685–696

    PubMed  CAS  Google Scholar 

  10. Guigui P, Levassor N, Rillardon L et al (2004) Valeur physiologique des paramètres pelviens et rachidiens de l’équilibre sagittal du rachis. Analyse d’une série de 300 volontaires. 2° Journées du Rachis de Paris. 11th International Conference on Lumbar stabilization. Sauramps Médical ed

  11. Huang RC, Girardi FP, Cammisa JFP et al (2003) Long-term flexion-extension range of motion of the prodisc total disc replacement. J Spinal Disord Tech 16:435–440

    Article  PubMed  Google Scholar 

  12. Kumar MN, Baklanov A, Chopin D (2001) Correlation between sagital plane changes and adjacent segment degeneration following lumbar spine fusion. Eur Spine J 10:314–319

    Article  PubMed  CAS  Google Scholar 

  13. Le Huec JC, Kiaer T, Friesem T et al (2003) Shock absorption in lumbar disc prosthesis. A preliminary mechanical study. J Spinal Disord Tech 16:346–351

    CAS  Google Scholar 

  14. Lee CS (1988) Accelerated degeneration of the segment adjacent to a lumbar fusion. Spine 13:375–377

    Article  PubMed  CAS  Google Scholar 

  15. Legaye J, Duval-Beaupère G, Hescquet J et al (1998) Pelvic incidence: a fundamental pelvic parameter for three dimensional regulation of spinal sagittal curves. Eur Spine J 7:99–103

    Article  PubMed  CAS  Google Scholar 

  16. Lemaire JP, Skalli W, Lavaste F et al (1997) Intervertebral disc prosthesis. Results and prospects for the year 2000. Clin Orthop Relat Res 337:64–76

    Article  PubMed  Google Scholar 

  17. Marcovschi S (2002) Validation du logiciel Spineview. ENSAM, Paris

  18. Mayer HM, Wiechert K, Korge A et al (2002) Minimally invasive total disc replacement: surgical technique and preliminary clinical results. Eur Spine J 11(suppl 2):S124–S130

    PubMed  Google Scholar 

  19. Mc Afee PC, Fedder IL, Saiedy S et al (2003) SB Charité disc replacement. Report of 60 prospective randomized cases in a U.S. center. J Spinal Disord Tech 16:424–433

    Google Scholar 

  20. Pearcy MJ, Bogduk N (1988) Instantaneous axes of rotation of the lumbar intervertebral joints. Spine 13:1033–1041

    Article  PubMed  CAS  Google Scholar 

  21. Skalli W, Lavaste F (2002) Informatique et modélisation statique/dynamique du rachis. Cahiers d’enseignement de la SOFCOT. Elsevier

  22. Stagnara P, De Mauroy JC, Dran G et al (1982) Reciprocal angulation of vertebral bodies in a sagittal plane: approach to references for the kyphosis and lordosis. Spine 7:335–342

    Article  PubMed  CAS  Google Scholar 

  23. Statacorp(2001) Stata statistical software: release 7.0.ed. College Station, TX

  24. Templier A (1998) Paramètres et méthodes d’évaluation des implants rachidiens lombaires. Paris

  25. Troyanovich SJ, Cailliet R, Janik TJ et al (1997) Radiographic mensuration characteristics of the sagittal lumbar spine from a normal population with a method to synthesize prior studies of lordosis. J Spinal Disord 10:380–386

    Article  PubMed  CAS  Google Scholar 

  26. Troyanovich SJ, Robertson GA, Harrison DD et al (1995) Intra- and interexaminer reliability of the chiropractic biophysics lateral lumbar radigraphic mensuration procedure. J Manipulative Physiol Ther 18:519–524

    PubMed  CAS  Google Scholar 

  27. Zigler JE, Burd TA, Vialle EN et al (2003) Lumbar spine arthroplasty. Early results using the Prodisc II: a randomized trial of arthroplasty versus fusion. J Spinal Disord 16:352–361

    Google Scholar 

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Authors and Affiliations

  1. Ecole Nationale Supérieure des Arts et Métiers, 151 boulevard de l’Hôpital, 75013, Paris, France

    C. Tournier, V. Lafage & W. Skalli

  2. Université Victor Segalen, Bordeaux2, 146 rue Léo Saignat, 33076, Bordeaux cedex, France

    S. Aunoble & J. C. Le Huec

  3. Clinique du Point Médical, Rond–point Nation, 21000, Dijon, France

    J. P. Lemaire

  4. Centre Hospitalier Universitaire Marseille Nord, Chemin des Bourrely, 13915, Marseille cedex 20, France

    P. Tropiano

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  1. C. Tournier
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  2. S. Aunoble
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  3. J. C. Le Huec
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  4. J. P. Lemaire
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  5. P. Tropiano
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  6. V. Lafage
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  7. W. Skalli
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Correspondence to C. Tournier.

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Tournier, C., Aunoble, S., Le Huec, J.C. et al. Total disc arthroplasty: consequences for sagittal balance and lumbar spine movement. Eur Spine J 16, 411–421 (2007). https://doi.org/10.1007/s00586-006-0208-7

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  • DOI: https://doi.org/10.1007/s00586-006-0208-7

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