TY - JOUR
T1 - Distribution of in vivo and in vitro range of motion following 1-level arthroplasty with the CHARITÉ artificial disc compared with fusion
AU - Cunningham, Bryan W.
AU - McAfee, Paul C.
AU - Geisler, Fred H.
AU - Holsapple, Gwen
AU - Adams, Karen
AU - Blumenthal, Scott L.
AU - Guyer, Richard D.
AU - Cappuccino, Andrew
AU - Regan, John J.
AU - Fedder, Ira L.
AU - Tortolani, P. Justin
PY - 2008/1
Y1 - 2008/1
N2 - Object. One of the goals of lumbar arthroplasty is to restore and maintain range of motion (ROM) and to protect adjacent levels from abnormal motion, which may be a factor in transition syndrome following arthrodesis. In this study, in vitro ROM results were compared with in vivo, 2-year postoperative radiographic ROM evaluations. Methods. Radiographs of patients enrolled in the CHARITÉ investigational device exemption study were analyzed at baseline and at 2 years postoperatively. The ROM in flexion/extension at the implanted and adjacent levels was measured, normalized, and compared with ROM results obtained using cadaver (in vitro) evaluations. Results. Preoperative ROM distributions in patients enrolled for arthroplasty or fusion at the L4-5 level was as follows: 28% motion was observed at L3-4, 35% at L4-5 and 37% at L5-S1. Following a one-level arthroplasty at L4-5, the in vivo ROM distribution from L-3 to S-1 at the 2-year time point was 36% at L3-4, 30% at L4-5 and 35% at L5-S1. Following a one-level fusion with BAK and pedicle screws at L4-5, the in vivo ROM distribution from L-3 to S-1 at the 2-year time point was 45% at L3-4, 9% at L4-5 and 46% at L5-S1. Conclusions. The baseline as well as the 2-year in vivo data confirmed previously published in vitro data. One-level arthroplasty was shown herein to replicate the normal distribution of motion of the intact spine.
AB - Object. One of the goals of lumbar arthroplasty is to restore and maintain range of motion (ROM) and to protect adjacent levels from abnormal motion, which may be a factor in transition syndrome following arthrodesis. In this study, in vitro ROM results were compared with in vivo, 2-year postoperative radiographic ROM evaluations. Methods. Radiographs of patients enrolled in the CHARITÉ investigational device exemption study were analyzed at baseline and at 2 years postoperatively. The ROM in flexion/extension at the implanted and adjacent levels was measured, normalized, and compared with ROM results obtained using cadaver (in vitro) evaluations. Results. Preoperative ROM distributions in patients enrolled for arthroplasty or fusion at the L4-5 level was as follows: 28% motion was observed at L3-4, 35% at L4-5 and 37% at L5-S1. Following a one-level arthroplasty at L4-5, the in vivo ROM distribution from L-3 to S-1 at the 2-year time point was 36% at L3-4, 30% at L4-5 and 35% at L5-S1. Following a one-level fusion with BAK and pedicle screws at L4-5, the in vivo ROM distribution from L-3 to S-1 at the 2-year time point was 45% at L3-4, 9% at L4-5 and 46% at L5-S1. Conclusions. The baseline as well as the 2-year in vivo data confirmed previously published in vitro data. One-level arthroplasty was shown herein to replicate the normal distribution of motion of the intact spine.
KW - Arthrodesis
KW - Arthroplasty
KW - Clinical trial
KW - Investigational device
KW - Range of motion
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U2 - 10.3171/SPI-08/01/007
DO - 10.3171/SPI-08/01/007
M3 - Article
C2 - 18173340
AN - SCOPUS:37849048025
SN - 1547-5654
VL - 8
SP - 7
EP - 12
JO - Journal of Neurosurgery: Spine
JF - Journal of Neurosurgery: Spine
IS - 1
ER -