Seminars in Spine Surgery
Volume 18, Issue 2 , Pages 109-116, June 2006

Explant Analysis of Total Disc Replacement

  • Paul A. Anderson, MD

      Affiliations

    • Department of Orthopedic Surgery and Rehabilitation and Department of Neurologic Surgery, University Of Wisconsin, Madison, WI.
    • Drs. Anderson and Toth are consultants for Medtronic Sofamor Danek.
    • Corresponding Author InformationAddress reprint requests to Paul A. Anderson, MD, Department of Orthopedic Surgery and Rehabilitation and Department of Neurologic Surgery, University of Wisconsin, 600 Highland Avenue K4/736, Madison, WI 53792.
    • ,
  • Steven M. Kurtz, PhD

      Affiliations

    • Exponent, Inc., Philadelphia, PA.
    • Implant Research Center, School of Biomedical Engineering, Science, and Health Systems and Department of Materials Engineering, Drexel University, Philadelphia, PA.
    • ,
  • Jeffrey M. Toth, PhD

      Affiliations

    • Department of Orthopaedic Surgery, The Medical College of Wisconsin, Milwaukee, WI.
    • Drs. Anderson and Toth are consultants for Medtronic Sofamor Danek.

Explant analysis of human disc prostheses allow early evaluation of the host response to the prosthesis and the response of the prosthesis from the host. Furthermore, early predictions of failure and wear can be obtained. Thus far, about 2-3% of disc prostheses have been removed. Observed wear patterns are similar to that of appendicular prostheses including abrasions/scratching, burnishing, surface deformation, fatigue, and embedded debris. Chemically the polymeric components have shown little degradation in short-term implantation. In metal on metal prostheses the histologic responses consist of large numbers of metallic particles with occasional macrophages and giant cells. Only rare cases of significant inflammatory response from polymeric debris have been seen.

Keywords:  intervertebral disc arthroplasty , wear , bone in-growth , explant analysis

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 Disclosure: The author’s institutions received research funding from Medtronic Sofamor Danek in support of the explant analysis described in the article.

PII: S1040-7383(06)00029-3

doi:10.1053/j.semss.2006.03.012

Seminars in Spine Surgery
Volume 18, Issue 2 , Pages 109-116, June 2006

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