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. 2012 Jun;21 Suppl 5(Suppl 5):S585-91.
doi: 10.1007/s00586-012-2271-6. Epub 2012 Apr 4.

Effect of prosthesis endplate lordosis angles on L5-S1 kinematics after disc arthroplasty

Parmenion P Tsitsopoulos  1 , Bartosz Wojewnik, Leonard I Voronov, Robert M Havey, Susan M Renner, Julia Zelenakova, Braden McIntosh, Gerard Carandang, Celeste Abjornson, Avinash G Patwardhan
Affiliations

Effect of prosthesis endplate lordosis angles on L5-S1 kinematics after disc arthroplasty

Parmenion P Tsitsopoulos et al. Eur Spine J. 2012 Jun.

Abstract

Objective: We hypothesized that L5-S1 kinematics will not be affected by the lordosis distribution between the prosthesis endplates.

Materials and methods: Twelve cadaveric lumbosacral spines (51.3 ± 9.8 years) were implanted with 6° or 11° prostheses (ProDisc-L) with four combinations of superior/inferior lordosis (6°/0°, 3°/3°, 11°/0°, 3°/8°). Specimens were tested intact and after prostheses implantation with different lordosis distributions. Center of rotation (COR) and range of motion (ROM) were quantified.

Results: Six-degree lordosis prostheses (n = 7) showed no difference in flexion-extension ROM, regardless of design (6°/0° or 3°/3°) (p > 0.05). In lateral bending (LB), both designs reduced ROM (p < 0.05). In axial rotation, only the 3°/3° design reduced ROM (p < 0.05). Eleven-degree lordosis prostheses (n = 5) showed no difference in flexion-extension ROM for either design (p > 0.05). LB ROM decreased with distributed lordosis prostheses (3°/8°) (p < 0.05). Overall, L5-S1 range of motion was not markedly influenced by lordosis distribution among the two prosthesis endplates. The ProDisc-L prosthesis design where all lordosis is concentrated in the superior endplate yielded COR locations that were anterior and caudal to intact controls. The prosthesis with lordosis distributed between the two endplates yielded a COR that tended to be closer to intact.

Conclusions: Further clinical and biomechanical studies are needed to assess the long-term impact of lordosis angle distribution on the fate of the facet joints.

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Figures

Fig. 1
Fig. 1
Anterior discectomy and insertion of ProDisc-L® artificial disc at the L5-S1 segment
Fig. 2
Fig. 2
Lateral plain radiographs showing the four prostheses: combinations at L5-S1 during testing: a 6°/0°, b 3°/3°, c 11°/0°, d 3°/8°
Fig. 3
Fig. 3
Flexion–extension at 400 N preload range of motion at L5-S1. Intact values and after insertion of the Pro Disc L® device. Non-distributed design denotes either 6°/0° 11°/0° whereas distributed design denotes 3°/3° or 3°/8°
Fig. 4
Fig. 4
Lateral bending range of motion at L5-S1. Intact values and after insertion of the Pro Disc L® device. Non-distributed design denotes either 6°/0° 11°/0° whereas distributed design denotes 3°/3° or 3°/8°
Fig. 5
Fig. 5
Axial rotation range of motion at L5-S1. Intact values and after insertion of the Pro Disc L® device. Non-distributed design denotes either 6°/0° 11°/0° whereas distributed design denotes 3°/3° or 3°/8°
Fig. 6
Fig. 6
The location of the center of rotation at L5-S1 during extension and flexion in the anteroposterior and cephalad–caudal axis. Intact values and after insertion of Pro Disc L® device with 6° of endplate lordosis. Old implant denotes 6°/0° and new implant denotes 3°/3°
Fig. 7
Fig. 7
The location of the center of rotation at L5-S1 during extension and flexion in the anteroposterior and cephalad–caudal axis. Intact values and after insertion of Pro Disc L® device with 11° of endplate lordosis. Old implant denotes 11°/0° and new implant denotes 3°/8°
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References

    1. Anderson PA, Rouleau JP. Intervertebral disc arthroplasty. Spine (Phila Pa 1976) 2004;29:2779–2786. doi: 10.1097/01.brs.0000146460.11591.8a. - DOI - PubMed
    1. Bertagnoli R, Kumar S. Indications for full prosthetic disc arthroplasty: a correlation of clinical outcome against a variety of indications. Eur Spine J. 2002;11(Suppl 2):S131–S136. - PMC - PubMed
    1. Delamarter R, Pradhan B. ProDisc-L total disc replacement. In: Yue J, Bertagnoli R, McAfee PC, An HS, editors. Motion preservation surgery of the spine. Philadelphia: Saunders Elsevier; 2008. pp. 318–325.
    1. Demetropoulos CK, Sengupta DK, Knaub MA, Wiater BP, Abjornson C, Truumees E, Herkowitz HN. Biomechanical evaluation of the kinematics of the cadaver lumbar spine following disc replacement with the ProDisc-L prosthesis. Spine (Phila Pa 1976) 2010;35:26–31. doi: 10.1097/BRS.0b013e3181c4eb9a. - DOI - PubMed
    1. Gaffey JL, Ghanayem AJ, Voronov ML, Havey RM, Carandang G, Abjornson C, Patwardhan AG. Effect of increasing implant height on lumbar spine kinematics and foraminal size using the ProDisc-L prosthesis. Spine (Phila Pa 1976) 2010;35:1777–1782. doi: 10.1097/BRS.0b013e3181ebaa4d. - DOI - PubMed

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