EARLY FUNCTIONAL OUTCOMES FOLLOWING TOTAL DISK ARTHROPLASTY WITH THE CHARITÉ III TOTAL DISK ENDOPROSTHESIS.

Abstract

We are reporting our case series of lumbar total disc endoprostheses. Oswestry and SF-36 scores were obtained from patients preoperatively and postoperatively for discs in situ for six, twelve and twenty-four months. Oswestry scores improved from fifty-three to thirty-two at six months (N=34); fifty-five to thirty-one at twelve months (N=28); and fifty-two to twenty-five at twenty-four months (N=17). SF-36 scores improved from thirty to fifty-four (physical) and forty to sixty-two (mental) at six months; twenty-nine to fifty-five (physical) and thirty-eight to sixty-three (mental) at twelve months; and twenty-nine to sixty-two (physical) and forty-one to sixty-seven (mental) at twenty-four months.

We report our results using the Charité III Endprosthesis in the treatment of degenerative disc disease.

Short term outcome for patients having undergone total disk arthroplasty support cautious optimism for continued implantation. Continued close follow-up is essential

Total disk arthroplasty for the treatment of degenerative disc disease is increasing in popularity. Expected FDA approval of several implants make accurate functional outcome reports essential to guide practice.

Disc replacements in situ for six months (N=34) improved in Oswestry scores from fifty-three to thirty-two. SF-36 physical scores for the same cohort improved from a mean of thirty to fifty-four and mental scores from forty to sixty-two. At one year (N=28), Oswestry scores improved from fifty-five to thirty-one. SF-36 physical scores improved from twenty-nine to fifty-five, and mental scores from thirty-eight to sixty-three. At two years (N=17), Oswestry scores improved from fifty-two to twenty-five. SF-36 physical scores improved from twenty-nine to sixty-two, and mental scores from forty-one to sixty-seven.

Using very narrow indications for application of this technique we have implanted fifty-one total disc arthroplasties. Cohorts were analyzed for outcome based on duration in situ of the implant. Through careful follow-up we have identified the following trends based on validated objective outcome measures including the Oswestry low back index and the Short Form 36. These outcome measures in addition to data reported separately demonstrating clear maintenance of interdiscal lumbar range of motion allow for cautious optimism regarding the continued application of total disc arthroplasty.