Two-year observation of artificial intervertebral disc replacement: results after supplemental ultra-high strength bioresorbable spinal stabilization.
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概要
- 論文の詳細を見る
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.
- American Association of Neurological Surgeonsの論文
著者
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Minami A
Dep. Of Orthopaedic Surgery Graduate School Of Medicine Hokkaido Univ.
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Minami Akio
Department Of Orthopaedic Surgery Hokkaido Graduate University School Of Medicine
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Takahata Masahiko
Department Of Orthopaedic Surgery Hokkaido University Graduate School Of Medicine
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Abumi Kuniyoshi
Department Of Orthopaedic Surgery Hokkaido University Graduate School Of Medicine
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Arisue Makoto
Oral And Maxillofacial Surgery School Of Dentistry Health Sciences Univ. Of Hokkaido
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Shikinami Yasuo
Takiron Co. Ltd
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Arisue Makoto
Department Of Orthopaedic Surgery Hokkaido University Graduate School Of Medicine
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Arisue Makoto
Department Of Oral Maxillo-facial Surgery School Of Dentistry Health Sciences University Of Hokkaido
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Kaneda Kiyoshi
Department Of Orthopaedic Surgery Hokkaido University Graduate School Of Medicine
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Kotani Yoshihisa
Dept. Of Orthop. Surg. Hokkaido University
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Arisue Makoto
Dep. Of Orthopaedic Surgery Graduate School Of Medicine Hokkaido Univ.
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Shono Yasuhiro
Department Of Orthopaedic Surgery Hokkaido University School Of Medicine
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