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01-12-2008 | Review

Design concepts in lumbar total disc arthroplasty

Authors: Fabio Galbusera, Chiara M. Bellini, Thomas Zweig, Stephen Ferguson, Manuela T. Raimondi, Claudio Lamartina, Marco Brayda-Bruno, Maurizio Fornari

Published in: European Spine Journal | Issue 12/2008

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.

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Title: Design concepts in lumbar total disc arthroplasty
Authors: Fabio Galbusera
Chiara M. Bellini
Thomas Zweig
Stephen Ferguson
Manuela T. Raimondi
Claudio Lamartina
Marco Brayda-Bruno
Maurizio Fornari
Publication date: 01-12-2008
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue 12/2008
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-008-0811-x

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Design concepts in lumbar total disc arthroplasty

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Other articles of this Issue 12/2008

The development of the axis vertebra: the key to a topographic classification of dens fractures

Response to reply to the letter to the editor concerning “Gebauer et al.: Subdental synchondrosis and anatomy of the axis in aging: a histomorphometric study on 30 autopsy cases. Eur Spine J 15(3):292–298, 2006”: The basis of the dens axis. Where is it located?

Posterior lumbar interbody fusion using rhBMP-2

Peridural scar and its relation to clinical outcome: a randomised study on surgically treated lumbar disc herniation patients

Back and hip extensor muscles fatigue in healthy subjects: task-dependency effect of two variants of the Sorensen test

Does socioeconomic status in adolescence predict low back pain in adulthood? A repeated cross-sectional study of 4,771 Danish adolescents