Journal
ORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH
Volume 100, Issue 1, Pages S1-S14Publisher
ELSEVIER MASSON, CORP OFF
DOI: 10.1016/j.otsr.2013.06.018
Keywords
Cervical total disc replacement (CTDR); Lumbar total disc replacement (LTDR); Cervical herniation; Cervicobrachial neuralgia; Low back pain
Categories
Ask authors/readers for more resources
Total disc replacement (TDR) (partial disc replacement will not be described) has been used in the lumbar spine since the 1980s, and more recently in the cervical spine. Although the biomechanical concepts are the same and both are inserted through an anterior approach, lumbar TDR is conventionally indicated for chronic low back pain, whereas cervical TDR is used for soft discal hernia resulting in cervicobrachial neuralgia. The insertion technique must be rigorous, with precise centering in the disc space, taking account of vascular anatomy, which is more complex in the lumbar region, particularly proximally to L5-S1. All of the numerous studies, including prospective randomized comparative trials, have demonstrated non-inferiority to fusion, or even short-term superiority regarding speed of improvement. The main implant-related complication is bridging heterotopic ossification with resulting loss of range of motion and increased rates of adjacent segment degeneration, although with an incidence lower than after arthrodesis. A sufficiently long follow-up, which has not yet been reached, will be necessary to establish definitively an advantage for TDR, particularly in the cervical spine. (C) 2014 Elsevier Masson SAS. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available