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Two-year observation of artificial intervertebral disc replacement: results after supplemental ultra-high strength bioresorbable spinal stabilization.
| Title: | Two-year observation of artificial intervertebral disc replacement: results after supplemental ultra-high strength bioresorbable spinal stabilization. |
| Authors: | Kotani, Yoshihisa Browse this author →KAKEN DB | | Abumi, Kuniyoshi Browse this author | | Shikinami, Yasuo Browse this author | | Takahata, Masahiko Browse this author | | Kadoya, Ken Browse this author | | Kadosawa, Tsuyoshi Browse this author | | Minami, Akio Browse this author →KAKEN DB | | Kaneda, Kiyoshi Browse this author |
| Keywords: | artificial intervertebral disc | | bioresorbable device | | hydroxyapatite | | poly-L-lactide | | lumbar spine | | biomechanics |
| Issue Date: | Apr-2004 |
| Publisher: | American Association of Neurological Surgeons |
| Journal Title: | Journal of Neurosurgery : Spine |
| Volume: | 100 |
| Issue: | 4 Supplement |
| Start Page: | 337 |
| End Page: | 342 |
| PMID: | 15070141 |
| Abstract: | 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. |
| Rights: | The final version of the paper was published in Journal of Neurosurgery:Spine, vol. 100-4 Supplement. For reuse of any of the materials, including editorial copy, figures, or tables please contact the Journal of Neurosurgery at jneuro@virginia.edu |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/14765 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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Submitter: 小谷 善久
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