Distribution of in vivo and in vitro range of motion following 1-level arthroplasty with the CHARITÉ artificial disc compared with fusion

Bryan W. Cunningham, Paul C. McAfee, Fred H. Geisler, Gwen Holsapple, Karen Adams, Scott L. Blumenthal, Richard D. Guyer, Andrew Cappuccino, John J. Regan, Ira L. Fedder, P. Justin Tortolani

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)7-12
Number of pages6
JournalJournal of Neurosurgery: Spine
Volume8
Issue number1
DOIs
StatePublished - Jan 2008
Externally publishedYes

Keywords

  • Arthrodesis
  • Arthroplasty
  • Clinical trial
  • Investigational device
  • Range of motion

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology

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