Intervertebral Disk Replacement - Keivan Anbarani's Electronic ...

Recently published reports reviewed the works of the Bryan disc, implanted into a total of
97 patients. Data was available for only 60 patients after a 6 month and 1 year follow-­‐up. 7
of the 11 reported failures have been secondary to incomplete neurologic decompression.
In addition, an unexpectedly high rate of heterotopic ossification (16 of the 97 patients)
was also observed. Of these 16 patients, 10 patients reported less than 2 degrees of motion
at the operated level (A.T. Villavicencio, MD, et al, 2007). The Cummins design also
reported similar results: 3 of 14 implanted discs were fused by 7–12.7 years follow-­‐up after
implantation. Table 6 below shows a comparison between the different types of disc
designs and the total amount implanted as of December 2004.
Table 6. Comparison of Disc Design Types
Bearing Surface
Material
Metal-on-Metal Prestige, Cervicore,
Kineflex|C, Secure-­‐
C
Disc Type Advantages Disadvantages Total
Implanted
(worldwide)
As of Dec. 2004
Common; balance
undesirable features
15
Heavy metal wear
debris; corrode;
fracture
Prestige: 500
Metal-on-Ceramic Cervidisc Cervidisc: 52
Metal-on-Polymer Bryan, Pro-­‐Disc C,
Porous Coated
Motion Device
(PCM), Disc,
Mobidisc
Polymer
Composite
Ceramic-on-
Polymer
Ceramic-on-
Ceramic
Common; promotes
high friction
NeoDisc High wear rate;
shock absorption
Cerpass Excellent wear
resistance
Inflammatory
response; wear rate
2x metal-­‐on-­‐metal
Low stiffness
Critical
manufacturing
processes; fracture
Bryan: 7000
Pro-­‐Disc C: 800
PCM: 300
Complications and Success Rates
Even if an excellent surgery has taken place for implantation by a good surgeon, long or
short term complications are bound to occur. Common complications of TDR are listed
below:
• Problems with anesthesia
• Thrombophlebitis (blood clots)
• Infections