Abstract
The implantation of lumbar disc prostheses based on different design concepts is widely accepted. This paper reviews currently available literature studies on the biomechanics of TDA in the lumbar spine, and is targeted at the evaluation of possible relationships between the aims of TDA and the geometrical, mechanical and material properties of the various available disc prostheses. Both theoretical and experimental studies were analyzed, by a PUBMED search (performed in February 2007, revised in January 2008), focusing on single level TDA. Both semi-constrained and unconstrained lumbar discs seem to be able to restore nearly physiological IAR locations and ROM values. However, both increased and decreased ROM was stated in some papers, unrelated to the clinical outcome. Segmental lordosis alterations after TDA were reported in most cases, for both constrained and unconstrained disc prostheses. An increase in the load through the facet joints was documented, for both semi-constrained and unconstrained artificial discs, but with some contrasting results. Semi-constrained devices may be able to share a greater part of the load, thus protecting the surrounding biological structure from overloading and possible early degeneration, but may be more susceptible to wear. The next level of development will be the biomechanical integration of compression across the motion segment. All these findings need to be supported by long-term clinical outcome studies.
| Original language | English |
|---|---|
| Pages (from-to) | 1635-1650 |
| Number of pages | 16 |
| Journal | European Spine Journal |
| Volume | 17 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Dec 2008 |
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Keywords
- Biomechanics
- Disc arthroplasty
- Lumbar
- Motion preservation
- Spinal alignment
ASJC Scopus subject areas
- Surgery
- Orthopedics and Sports Medicine
Cite this
Design concepts in lumbar total disc arthroplasty. / Galbusera, Fabio; Bellini, Chiara M.; Zweig, Thomas; Ferguson, Stephen; Raimondi, Manuela T.; Lamartina, Claudio; Brayda-Bruno, Marco; Fornari, Maurizio.
In: European Spine Journal, Vol. 17, No. 12, 12.2008, p. 1635-1650.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Design concepts in lumbar total disc arthroplasty
AU - Galbusera, Fabio
AU - Bellini, Chiara M.
AU - Zweig, Thomas
AU - Ferguson, Stephen
AU - Raimondi, Manuela T.
AU - Lamartina, Claudio
AU - Brayda-Bruno, Marco
AU - Fornari, Maurizio
PY - 2008/12
Y1 - 2008/12
N2 - The implantation of lumbar disc prostheses based on different design concepts is widely accepted. This paper reviews currently available literature studies on the biomechanics of TDA in the lumbar spine, and is targeted at the evaluation of possible relationships between the aims of TDA and the geometrical, mechanical and material properties of the various available disc prostheses. Both theoretical and experimental studies were analyzed, by a PUBMED search (performed in February 2007, revised in January 2008), focusing on single level TDA. Both semi-constrained and unconstrained lumbar discs seem to be able to restore nearly physiological IAR locations and ROM values. However, both increased and decreased ROM was stated in some papers, unrelated to the clinical outcome. Segmental lordosis alterations after TDA were reported in most cases, for both constrained and unconstrained disc prostheses. An increase in the load through the facet joints was documented, for both semi-constrained and unconstrained artificial discs, but with some contrasting results. Semi-constrained devices may be able to share a greater part of the load, thus protecting the surrounding biological structure from overloading and possible early degeneration, but may be more susceptible to wear. The next level of development will be the biomechanical integration of compression across the motion segment. All these findings need to be supported by long-term clinical outcome studies.
AB - The implantation of lumbar disc prostheses based on different design concepts is widely accepted. This paper reviews currently available literature studies on the biomechanics of TDA in the lumbar spine, and is targeted at the evaluation of possible relationships between the aims of TDA and the geometrical, mechanical and material properties of the various available disc prostheses. Both theoretical and experimental studies were analyzed, by a PUBMED search (performed in February 2007, revised in January 2008), focusing on single level TDA. Both semi-constrained and unconstrained lumbar discs seem to be able to restore nearly physiological IAR locations and ROM values. However, both increased and decreased ROM was stated in some papers, unrelated to the clinical outcome. Segmental lordosis alterations after TDA were reported in most cases, for both constrained and unconstrained disc prostheses. An increase in the load through the facet joints was documented, for both semi-constrained and unconstrained artificial discs, but with some contrasting results. Semi-constrained devices may be able to share a greater part of the load, thus protecting the surrounding biological structure from overloading and possible early degeneration, but may be more susceptible to wear. The next level of development will be the biomechanical integration of compression across the motion segment. All these findings need to be supported by long-term clinical outcome studies.
KW - Biomechanics
KW - Disc arthroplasty
KW - Lumbar
KW - Motion preservation
KW - Spinal alignment
UR - http://www.scopus.com/inward/record.url?scp=57049171892&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=57049171892&partnerID=8YFLogxK
U2 - 10.1007/s00586-008-0811-x
DO - 10.1007/s00586-008-0811-x
M3 - Article
C2 - 18946684
AN - SCOPUS:57049171892
VL - 17
SP - 1635
EP - 1650
JO - European Spine Journal
JF - European Spine Journal
SN - 0940-6719
IS - 12
ER -