Stationary fluoroscopy has been a viable resource for determining in vivo knee kinematics, but limitations have restricted the use of this technology. Patients can only perform certain normal daily living activities while using stationary fluoroscopy and must conduct the activities at speeds that are slower than normal to avoid ghosting of the images. More recently, a Mobile Tracking Fluoroscopic (MTF) unit has been developed that can track patients in real-time as he/she performs various activities at normal speeds (Figure 1). Therefore, the objective of this study was to compare in vivo kinematics for patient's evaluated using stationary and mobile fluoroscopy to determine potential advantages and disadvantages for use of these technologies. The MTF is a unique mobile robot that can acquire real-time x-ray records of hip, knee, or ankle joint motion while a subject walks/manoeuvres naturally within a laboratory floor area. By virtue of its mechanizations, test protocols can involve many types of manoeuvres such as chair rises, stair climbing/descending, ramp crossing, walking, etc. Because the subjects are performing such actions naturally, the resulting fluoroscope images reflect the full functionality of their musculoskeletal anatomy. Patients in the study were initially fluoroscoped using a stationary unit and then using the MTF unit.INTRODUCTION:
METHODS:
The majority of spine patients present with discogenic low back pain, originating from either degenerative disc disease (DDD) or internal disc disruption (IDD). Successful treatment of this patient population relies on obtaining precision diagnosis and careful patient selection, as well as matching the pathology with reliable technology. Total disc replacement (TDR), as an alternative to spinal fusion in the treatment of DDD or IDD, has been studied and reported for several decades in long-term follow-up studies and in several randomized control trials. This prospective study presents a single surgeon experience with two-level CHARITÉ® TDR in 84 consecutive patients, with minimum follow-up of 5 years. The aims of the study were to assess the clinical outcomes of two-level TDR in patients with DDD/IDD. Based on the literature review conducted, this study is considered the largest single surgeon series experience with the two-level CHARITÉ® TDR in the treatment of lumbar DDD, with a minimum follow-up of 5 years reported to date. Between January 1997 and March 2006, n=84 consecutive patients underwent two-level TDR for the treatment of two-level DDD or IDD discogenic axial low back pain with or without radicular pain. All patients completed self-assessment outcome questionnaires pre and postoperatively (3, 6, 12 months, and yearly thereafter), including Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ) and Visual Analogue Score (VAS) for back and leg pain.Introduction
Materials and Methods