By Robert Gunzburg, H. Michael Mayer, Marek Szpalski, Max Aebi

Joint substitute is a logical step within the remedy of critical joint pathologies with irreversible lesions resisting conservative remedy. on the spinal point, arthrodesis turned, very early, the highest quality of therapy for critical intervertebral disc pathologies. the following logical step used to be to examine practical substitute, and this step was once taken as early as 1956, whilst the 1st intervertebral implant used to be defined. notwithstanding, it took many extra years and an exceptional number of proposed implant designs earlier than medical functions might be attempted.

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Extra resources for Arthroplasty of the Spine

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This important aspect of spinal biomechanics is replicated in the functional motion of the SB Charite, due to its three-component set-up, which incorporates a floating sliding core, whose convex surfaces are encased in the concave cavities of the metal endplates (Fig. 6). In vitro evaluations carried out by Ahrens [5, 24] of the mobility of the L4/L5 motion segment in fresh frozen cadavers with most ligamentous structures intact have revealed a similar mobility in those with and those without implanted SB Charite disc, in extension and flexion as well as right and left bending.

Only two nucleus implants are currently used, with different indication criteria: the Nucleoplasty Spiral (Sulzer Medica) is indicated after simple microdiscectomy for lumbar disc herniation. It serves as a spaceholder and is supposed to prevent early disc height loss following discectomy [16, 18]. The indication for implantation of the Prosthetic Disc Nucleus (PDN) is different. It is used in patients with discogenic low-back pain without previous operations. It can be implanted through a traditional PUP approach [31].

This concept has been successfully tested in an animal study [24, 25] and in non-cemented joint replacements such as pressfit hip cups, ankle joint prostheses and dental implants [23]. The coating consists of three layers. The first two layers are of commercially pure titanium (Ti) - the first layer provides a special strong bond between the cobalt-chrome endplate and the coating, and the second layer of plasmasprayed Ti provides the desired pore size of 75-300 /-lm. 9% in a baboon study (coronal diamond cut section, courtesy of Dr.

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