Lumbar Arthroplasty: Past, Present, and Future. [Review]

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Citation: Neurosurgery. 86(2):155-169, 2020 02 01.PMID: 31724719Institution: MedStar Washington Hospital CenterDepartment: NeurosurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Arthroplasty/td [Trends] | *Intervertebral Disc Degeneration/dg [Diagnostic Imaging] | *Intervertebral Disc Degeneration/su [Surgery] | *Lumbar Vertebrae/dg [Diagnostic Imaging] | *Lumbar Vertebrae/su [Surgery] | *Prostheses and Implants/td [Trends] | Adult | Aged | Arthroplasty/is [Instrumentation] | Biomechanical Phenomena | Female | Forecasting | Humans | Intervertebral Disc/dg [Diagnostic Imaging] | Intervertebral Disc/su [Surgery] | Male | Prosthesis Design/is [Instrumentation] | Prosthesis Design/td [Trends] | Spinal Fusion/mt [Methods]Year: 2020ISSN:
  • 0148-396X
Name of journal: NeurosurgeryAbstract: Lumbar degenerative disc disease is a pathologic process that affects a large portion of our aging population. In the recent past, surgical treatment has involved fusion procedures. However, lumbar disc arthroplasty and replacement provides an alternative for carefully selected patients. It provides the major advantage of motion preservation and thus keeps adjacent segments from significantly progressive degeneration. The history of lumbar disc replacement has roots that start in the 1960s with the implantation of stainless-steel balls. Decades later, multiple implants with different material design and biomechanical properties were introduced to the market. New third-generation implants have made great strides in improved biomechanics and clinical outcomes. Although there is room for further advancement and studies are warranted to assess the long-term durability and sustainability of lumbar disc arthroplasty, it has certainly proven to be a very acceptable alternative within the surgical armamentarium that should be offered to patients who meet indications. In this review we present an overview of lumbar disc arthroplasty including its history, indications, biomechanics, challenges, and future directions. Copyright (c) 2019 by the Congress of Neurological Surgeons.All authors: Dowlati E, Garica R, Sandhu FAOriginally published: Neurosurgery. 2019 Nov 14Fiscal year: FY2020Digital Object Identifier: Date added to catalog: 2019-12-04
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Journal Article MedStar Authors Catalog Article 31724719 Available 31724719

Lumbar degenerative disc disease is a pathologic process that affects a large portion of our aging population. In the recent past, surgical treatment has involved fusion procedures. However, lumbar disc arthroplasty and replacement provides an alternative for carefully selected patients. It provides the major advantage of motion preservation and thus keeps adjacent segments from significantly progressive degeneration. The history of lumbar disc replacement has roots that start in the 1960s with the implantation of stainless-steel balls. Decades later, multiple implants with different material design and biomechanical properties were introduced to the market. New third-generation implants have made great strides in improved biomechanics and clinical outcomes. Although there is room for further advancement and studies are warranted to assess the long-term durability and sustainability of lumbar disc arthroplasty, it has certainly proven to be a very acceptable alternative within the surgical armamentarium that should be offered to patients who meet indications. In this review we present an overview of lumbar disc arthroplasty including its history, indications, biomechanics, challenges, and future directions. Copyright (c) 2019 by the Congress of Neurological Surgeons.

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