Lumbar intervertebral disc replacement using bioabsorbable self-reinforced poly-L-lactide full-threaded screws, or cylindrical implants of polylactide polymers, bioactive glass and Polyactive™

2003 ◽  
Vol 16 (03) ◽  
pp. 138-144 ◽  
Author(s):  
P. Ylinen ◽  
R.-M. Tulamo ◽  
M. Kellomäki ◽  
P. Türmälä ◽  
P. Rokkanen ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Intervertebral Discs ◽  
Growing Pigs ◽  
Disc Replacement ◽  
Intervertebral Space ◽  
Lumbar Intervertebral Disc ◽  
Histological Changes ◽  
Preliminary Study ◽  
Artificial Intervertebral Disc

SummaryIntervertebral disc surgery leads to changes in the segmental anatomy and mobility, and subsequently to degenerative changes in the lumbar spine. Artificial intervertebral disc implants sufficient to replace the human lumbar intervertebral disc have been developed and the requirements for these defined. This is to our knowledge the first study on bioabsorbable intervertebral disc replacement implants. SR-PLLA screws, previously used in orthopaedic internal fixations, and cylindrical implants, specifially developed for this experimental preliminary study, were used to replace lumbar intervertebral discs of growing pigs. After a 15-week follow-up period, the radiological and histological changes in the intervertebral spaces were analyzed. The cylindrical implants were able to prevent narrowing of discectomied spaces, and tissue regeneration in the intervertebral space was induced and occured simultaneously with degradation of the implant.

Introduction of Disc Material into the Vertebral Canal by Fenestration of Thoracolumbar Discs Following Decompressive Surgery

2019 ◽  
Vol 33 (01) ◽  
pp. 066-070
Author(s):  
Georgina Harris ◽  
Paul Freeman
Keyword(s):  
Intervertebral Disc ◽  
Intervertebral Discs ◽  
Decompressive Surgery ◽  
Common Disease ◽  
Additional Material ◽  
Vertebral Canal ◽  
Disc Material ◽  
Before And After ◽  
Preliminary Study ◽  
Disc Extrusion

Abstract Objective Intervertebral disc extrusion is a common disease affecting chondrodystrophic dogs. It has been reported that fenestration of thoracolumbar intervertebral discs reduces recurrence of disc extrusion and is associated with a low complication rate. One complication reported is iatrogenic introduction of disc material into the canal directly following fenestration. This study aimed to ascertain if, and at what frequency, additional disc material may be introduced into the vertebral canal by fenestration of the affected disc following decompressive surgery. Study Design Twenty-one dogs that underwent hemilaminectomy and disc fenestration for the treatment of thoracolumbar intervertebral disc extrusion had intraoperative assessment of the vertebral canal before and after fenestration. The spinal cord was first decompressed by hemilaminectomy and removal of all visible extruded disc material within the vertebral canal. Once no further material was visible, manual fenestration of the affected disc was performed. The vertebral canal was re-inspected, and the presence or absence of additional material was noted and included in the surgery report. Results Seven dogs showed the presence of new disc material in the vertebral canal post fenestration.This preliminary study shows that additional disc material can be forced into the vertebral canal by fenestration following decompressive surgery, with a frequency of 7/21. Conclusion This illustrates the importance of checking the vertebral canal after fenestration of an extruded intervertebral disc.

Nucleus Implant Parameters Significantly Change the Compressive Stiffness of the Human Lumbar Intervertebral Disc

2005 ◽  
Vol 127 (3) ◽  
pp. 536-540 ◽  
Author(s):  
Abhijeet Joshi ◽  
Samir Mehta ◽  
Edward Vresilovic ◽  
Andrew Karduna ◽  
Michele Marcolongo
Keyword(s):  
Back Pain ◽  
Intervertebral Disc ◽  
Lower Back Pain ◽  
Recent Trend ◽  
Intervertebral Discs ◽  
Geometric Parameters ◽  
Synthetic Material ◽  
Lumbar Intervertebral Disc ◽  
Compressive Stiffness ◽  
Lower Back

Nucleus replacement by a synthetic material is a recent trend for treatment of lower back pain. Hydrogel nucleus implants were prepared with variations in implant modulus, height, and diameter. Human lumbar intervertebral discs (IVDs) were tested in compression for intact, denucleated, and implanted condition. Implantation of nucleus implants with different material and geometric parameters into a denucleated IVD significantly altered the IVD compressive stiffness. Variations in the nucleus implant parameters significantly change the compressive stiffness of the human lumbar IVD. Implant geometrical variations were more effective than those of implant modulus variations in the range examined.

scholarly journals Two-year observation of artificial intervertebral disc replacement: results after supplemental ultra—high strength bioresorbable spinal stabilization

2004 ◽  
Vol 100 (4) ◽  
pp. 337-342 ◽  
Author(s):  
Yoshihisa Kotani ◽  
Kuniyoshi Abumi ◽  
Yasuo Shikinami ◽  
Masahiko Takahata ◽  
Ken Kadoya ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Bone Ingrowth ◽  
Intervertebral Discs ◽  
Disc Replacement ◽  
Segmental Mobility ◽  
Content Type ◽  
Spinal Stabilization ◽  
Titanium Screws ◽  
Flexion Extension ◽  
Fine Print

Object. This 2-year experimental study was conducted to investigate the efficacy of a bioactive three-dimensional (3D) fabric disc for lumbar intervertebral disc replacement. The authors used a bioresorbable spinal fixation rod consisting of a forged composite of particulate unsintered hydroxyapatite/poly-l-lactide acid (HA/PLLA) for stability augmentation. The biomechanical and histological alterations as well as possible device-related loosening were examined at 2 years postoperatively. Methods. Two lumbar intervertebral discs (L2–3 and L4–5) were replaced with the 3D fabric discs, which were augmented by two titanium screws and a spanning bioresorbable rod (HA/PLLA). The segmental biomechanics and interface bone ingrowth were investigated at 6, 15, and 24 months postoperatively, and results were compared with the other two surgical groups (3D fabric disc alone; 3D fabric disc with additional anterior instrumentation stabilization). The 3D fabric disc and HA/PLLA—spinal segments demonstrated segmental mobility at 15 and 24 months; however, the range of motion (ROM) in flexion—extension decreased to 49 and 40%, respectively, despite statistically equivalent preserved torsional ROM. Histologically there was excellent osseous fusion at the 3D fabric disc surface—vertebral body interface. At 2 years posttreatment, no adverse tissue reaction nor aseptic loosening of the device was observed. Conclusions. Intervertebral disc replacement with the 3D fabric disc was viable and when used in conjunction with the bioresorbable HA/PLLA spinal augmentation. Further refinements of device design to create a stand-alone type are necessary to obviate the need for additional spinal stabilization.

scholarly journals Quantitative assessment of the lumbar intervertebral disc via T2 shows excellent long-term reliability

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249855
Author(s):  
Daniel L. Belavy ◽  
Patrick J. Owen ◽  
Gabriele Armbrecht ◽  
Martin Bansmann ◽  
Jochen Zange ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Prospective Studies ◽  
Quantitative Assessment ◽  
Spin Echo ◽  
Intervertebral Discs ◽  
Lumbar Intervertebral Disc ◽  
Lower Test ◽  
Test Retest Reliability

Methodologies for the quantitative assessment of the spine tissues, in particular the intervertebral disc (IVD), have not been well established in terms of long-term reliability. This is required for designing prospective studies. 1H water T2 in the IVD (“T2”) has attained wider use in assessment of the lumbar intervertebral discs via magnetic resonance imaging. The reliability of IVD T2 measurements are yet to be established. IVD T2 was assessed nine times at regular intervals over 368 days on six anatomical slices centred at the lumbar spine using a spin-echo multi-echo sequence in 12 men. To assess repeatability, intra-class correlation co-efficients (ICCs), standard error of the measurement, minimal detectable difference and co-efficients of variation (CVs) were calculated along with their 95% confidence intervals. Bland-Altman analysis was also performed. ICCs were above 0.93, with the exception of nuclear T2 at L5/S1, where the ICC was 0.88. CVs of the central-slice nucleus sub-region ranged from 4.3% (average of all levels) to 10.1% for L5/S1 and between 2.2% to 3.2% for whole IVD T2 (1.8% for the average of all levels). Averaging between vertebral levels improved reliability. Reliability of measurements was least at L5/S1. ICCs of degenerated IVDs were lower. Test-retest reliability was excellent for whole IVD and good to excellent for IVD subregions. The findings help to establish the long-term repeatability of lumbar IVD T2 for the implementation of prospective studies and determination of significant changes within individuals.

scholarly journals A study of functional outcome of laminectomy and discectomy in lumbar intervertebral disc prolapse (a comparison of retrospective and prospective analysis)

2015 ◽  
Vol 05 (04) ◽  
pp. 062-065
Author(s):  
Sanath Kumar Shetty ◽  
Arjun Ballal ◽  
Lawrence John Mathias ◽  
H. Ravindranath Rai
Keyword(s):  
Intervertebral Disc ◽  
Functional Outcome ◽  
Clinical Presentation ◽  
Disc Prolapse ◽  
Lumbar Intervertebral Disc ◽  
Excellent Outcome ◽  
Group I ◽  
Group Ii

Abstract Background: Back pain is considered as one of the most unrewarding problems in clinical medicine. There have existed several etiologies for the same and most of them do not have an ideal clinical presentation. Only those syndromes associated with neurologic compression of the cauda equina or nerve roots, have reasonably well understood clinical presentation. Aims: The aim of the study was to analyse and compare the functional outcome of laminectomy and discectomy in lumbar intervertebral disc prolapse in short and long term follow up. Materials and methods: Our study included a total of 50 diagnosed cases of lumbar intervertebral disc prolapse between age group of 40-70 years. The patients were subdivided into two groups. The first group was a retrospective group and included patients who had undergone laminectomy and discectomy between January 1993 and December 2003 with an average follow up of 3.68 years. Group two (prospective group) consisted of patients between January 2004 and December 2004 who underwent laminectomy and discectomy, with a follow up of 6 months.The subjective assessment was done using the Oswestry disability index (O.D.I). the results obtained with assessment of group I and group II were tabulated compared. Statistical analysis was done using the chi square test. Results: The results were noted to be 76% excellent, 8% good and 16% with poor scores in group I. 96% with excellent, no patients with good scores and 4% with poor scores in group II as per the O.D.I. Conclusion: We conclude saying that laminectomy and discectomy had excellent outcome in terms of pain relief in terms of long term and short term follow up.

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