Preliminary Result Total disc replacement

Slides:

Advertisements

Similar presentations

Michael W. Meriwether, M.D., P.A. Neurosurgeon, Board Certified Sarasota, Florida USA Endoscopic Laser Lumbar Disc Decompression.

Advertisements

Update on Cervical Disc Arthroplasty

Process Study 24-Month Results October 1, 2008 (abridged)

PROCESS vs. WA State SCS Study A Comparison of Study Design, Patient Population, and Outcomes August 29,2007.

Long-Term Data for 884 Patients Show Vertebroplasty for Osteoporotic Spinal Fractures Provides Dramatic Pain Relief, Greatly Decreases Disability Giovanni.

British Spinal Registry British Association of Spine Surgeons Middlesbrough February 2007 John O’Dowd Nicky Courtier.

DePuy Spine confidential information. Do not duplicate

The different types of patients with Sciatica from a lumbar disc Manoj Krishna. Spinal Surgeon

Causes of Stenosis Degenerative spondylo-listhesis Facet subluxation and hypertrophy Pagets disease Tumour Facet joint cyst Congenital- achondroplasia.

E-Poster #510 Mineralized Collagen and Bone Marrow Aspirate in Anterior Interbody Carbon Fiber Cages Achieve High Fusion Rates in Multilevel Adult Spinal.

Malignant Pleural Mesothelioma Post- Irradiation Treatment for Hodgkin’s Lymphoma Thea Price MD, R.V. Sooppan MD, Michael Walker MD Department of Thoracic.

ARTIFICIAL DISC VERSUS FUSION A prospective randomised study with 2-year follow-up on 99 patients.

Bone is one of the most frequent sites of spread for many common cancers (breast, prostate, lung, kidney, multiple myeloma, etc.). Painful Bone metastases.

InFUSE ™ Bone Graft / LT-CAGE ™ Lumbar Tapered Fusion Device IDE Clinical Results G Hallett H. Mathews, M.D. Richmond, Virginia.

5 Years Results of Off-Pump VS On-Pump CABG 5 Years Results of Off-Pump VS On-Pump CABG Prospective Non-randomized Comparative Study Piya Cherntanomwong*,

ARTIFICIAL DISK REPLACEMENT IN THE LUMBAR SPINE By: Trevor Bernier.

SURGICAL TREATMENT OF CERVICAL DEGENERATIVE DISC DISEASE WITH MYELORADICULOPATHY: TWO-LEVEL ANTERIOR DISCECTOMY VERSUS ONE LEVEL ANTERIOR CORPECTOMY Istanbul.

1 DJ5895D A CLINICAL REVIEW OF CERVICAL AND LUMBAR ARTHROPLASTY.

Spinal Cord Stimulators in Neuropathic Pain. Introduction Chronic pain is very common Immense physical, psychological, societal impact Financial burden.

Lumbar Surgery Audit Period 1 st Jan st Dec 2007 Presented at Britspine teaching Hospital consultants 2 District General Hospitals.

Disc Degeneration Wayne Cheng, MD, Dept. of Orthopaedic Surgery Basic Science May 13, 2014.

Glenn R. Buttermann, MD Lumbar Spinal Disc Replacement in a Community Practice Setting: Early Results 1.

Seeking Patients for Back Pain Study DIAM ™ Spinal Stabilization System vs. Conservative Care Therapies Wayne Cheng, MD Caution: Investigational device,

5-year Results from a Prospective, Randomized Study of a Posterior Dynamic Stabilization System for the Lumbar Spine: DYNESYS Peter Gerszten 1, R. Davis.

Prevalence of Heterotopic Ossification Following Total Disc Replacement by P. Justin Tortolani, Bryan W. Cunningham, MMech Eng, Paul C. McAfee, Gwen A.

Pain Structures Neck Causes Chronic Neck Pain Bogduk, 1993 Facet alone 23% (31%) Disc alone 20% (12%) Facet and Disc - 41% ? 17%

Upper Tibia Osteotomy Single incision & MIS H.Makhmalbaf MD Consultant Orthopaedic & Knee Surgeon Mashad University.

Learn More At: Dose-Response and Dose- Complications Relationships in Stereotactic Radiosurgery for Trigeminal Neuralgia Sandra.

Clinical Review Barbara Buch, M.D. Orthopaedic Surgeon FDA Orthopaedic Devices Branch.

Minimally Invasive Hip Surgery. What is Minimally Invasive Hip Surgery? A new surgical technique A new surgical technique Uses traditional hip implants.

THE FEASIBILITY OF A NOVEL ULTRASOUND GUIDED VASCULAR ACCESS DEVICE: A PILOT STUDY Robinson M Ferre, MD, FACEP Vanderbilt University Medical Center

AxiaLIF Wayne Cheng, MD Head of Spine Service Associate Professor, Department of Orthopedic Surgery Loma Linda University Medical Center Basic Science.

FORM AND FUNCTION OF INTERVERTEBRAL DISK Wayne Cheng, MD Loma Linda University Medical Center Basic Science SEPT 20, 2011.

MATT MAC ANDREW AND DREW 1 ST BLOCK-SNEEDBIOTECH Joint Redesign Project.

A New Monolaterally Inserted Interspinous Device in the Mini- Invasive Surgical Treatment of Lumbar Disc Herniation associated with Lumbar Canal Stenosis.

Analysis of Learning Curve for Minimally Invasive Transforaminal Lumbar Interbody Fusion Byung-Joon Shin, Jae Chul Lee, Hae-Dong Chang, Su-Jin Yun, Yon-Il.

Section 4: General surgery. Volume of non-elective appendicectomies carried out in patients aged 12 years and over.

Cincinnati Children’s Hospital Medical Center

ORLY HALACHMI- EYAL JNC APRIL 2012 Adjustable sutures – WHY.

A Comparison of Patients Treated with Shilla Growing Rods for Early Onset Scoliosis 9 th International Congress on Early Onset Scoliosis November 19-20,

In the first 5 years of Treatment, the Charges for Guided Growth Constructs are 30% less than Growing Rods Lindsay M. Andras MD 1, Liam Harris BS 1, Scott.

A minimum of 2 year follow up of 22 EOS patients who were treated with 2 nd generation MCGR Karsten Ridderbusch, Christian Hagemann, Ralf Stücker Childrens.

Role of Hip Resurfacing for the older patients Pascal A. Vendittoli, MD MSc FRSC Montréal, Canada.

Review of Inpatient Musculoskeletal Consults Utilizing Musculoskeletal Ultrasound Mindy Loveless, MD Clinical Assistant Professor University of Washington.

Ultrasound Guided Nerve Twitch Darwin C. Viernes, MD Regional Anesthesia Fellow Mentor: Loreto Lollo, MD Mapping of Sciatic Nerve.

Motion Preservation Projects Wayne Cheng, MD Head of Spine Service Associate Professor, Department of Orthopedic Surgery Loma Linda University Medical.

Final Fusion in Patients Treated with Rib Based Distraction: A Review of Peri- operative Results THE UNIVERSITY OF UTAH Department of Orthopaedic Surgery.

: Intermittent Neurogenic Claudication Aperius ® Percutaneous Interspinous Spacer F. Collignon, P. Fransen, D Morelli, N. Craig, J. Van Meirhaeghe For.

Burt Yaszay, MD Jeff B. Pawelek, BS John Emans, MD Patrick Cahill, MD Bo Robertson Gregory M. Mundis, MD Behrooz A. Akbarnia, MD Children’s Spine Study.

Review of Inpatient Musculoskeletal Consults Utilizing Musculoskeletal Ultrasound Mindy Loveless, MD Clinical Assistant Professor University of Washington.

Bassem A Georgy, MD North County Radiology Assistant Professor of Radiology University of San Diego, California.

Department of Cardiothoracic and Vascular Surgery 1 School of Public Health 2 The University of Texas Medical School at Houston Memorial Hermann Heart.

Enrico Piovan Neroradiology Dpt. Verona - Italy. SPINAL STRENGTHENING from Feb to Sep Procedures 546 Patients RATIO PROCEDURES / PATIENTS.

Surgical Treatment Of Acromioclavicular Dislocations: A Comparative Study Of Suture Ethiband N:5 With Semitendinosus Autograft Tendon Mohsen Mardani-Kivi.

OSTEOARTHRITIS OF THE KNEE DR. IRA GELB, POTOMAC VALLEY ORTHOPEDICS Kiran Pant, Intern/Mentor Program Mount Hebron High School.

Mr A Bayan MBChB, FRACS(Ortho) Orthopaedic Surgeon.

SPINE ORTHOSES Michael Zlowodzki MD University of Minnesota Department of Orthopaedic Surgery.

G Swamy, A Bishnoi, H Majeed, Z Klezl, D Calthorpe, R Bommireddy Royal Derby Hospital.

Salvage Nipple-Sparing Mastectomy and Immediate Breast Reconstruction after Previous Breast Conservation Therapy: Same Safety, Better Cosmesis Che-Hsiung.

Distal Third Femoral Shaft Fracture: Antegrade vs. Retrograde Nailing Michael Zlowodzki MD University of Minnesota Department of Orthopaedic Surgery.

Review of ankle fusions at PCEA Kikuyu Hospital M. M Khanbhai, V. Chauhan, F. Gitonga, M. Maru.

First Year Experience with Lipogems

Hybrid and Spanning External Fixation

Hallett H. Mathews, M.D. Richmond, Virginia

Magnetically Controlled Growing Rods: Sagittal Plane Analysis and the Risk of Proximal Junctional Kyphosis Purnendu Gupta, Felix Brassard, Jennifer Schottler,

A case study demonstrating the limitations of a single-disc replacement in correcting a spinal flat-back deformity: (a–c) a 45-year-old obese male patient.

John A Heflin, MD John T. Smith, MD

Amer F. Samdani, MD Tricia St. Hilaire John Emans, MD John Smith, MD

Management of Implant Related Infections:

Presentation transcript:

Preliminary Result Total disc replacement Wayne Cheng, MD Assistant Professor Department of Orthopaedic Surgery Loma Linda University Medical Center September 8, 2006

HISTORY

HISTORY 1955 Hamby/Cleveland 1962 Nachemson 1964 Fernstrom Cement injection 1962 Nachemson Silicone injection 1964 Fernstrom Ball bearing 1970’s to 80’s Urbaniak Lee Kotsuik Steffee

History-Present Charite’ (depuy) Oct 04 Prodisc (synthes) Aug 06 Flexicore (stryker) Maverick (Medtronic)

Loma Linda Univ. Medical Center feb 2005 to present 31 patients, 37 discs Male : female = 14 : 17 Age 24 to 66 (avg. 40.7) f/u 18 month to 6 wks (average 7 month)

Levels Levels L5/S1 L45 L34 L23 # of TDR 16 14 6 1 Total number of disc replacement = 37

Simple TDR vs. hybrid

Type of surgery Type of surgery # of patients 1 level TDR 17 4 2 level hybrid 5 3 level hybrid

Implants Charite 33 TDR Kineflex 4 TDR

Pain Relief (VAS)

Pain & Function (ODI)

Patient Satisfaction

“ will you make the same choice again?”

COMPARE TO IDE STUDY (VAS)

Simple TDR vs. Hybrid (VAS for pain)

COMPLICATION Secondary surgery 7 Leg pain 6 Malposition of hardware 5 ileus vascular injury 3 fracture 1 Heterotopic ossification Retrograde ejaculation

Complication 1 level TDR 2 level TDR 2 level hybrid 3 level hybrid Malposition 0/17 1/4 3/5 1/5 2nd procedure 2/17(pain pump, fracture) 2/4 (post decomp, scoliosis) 2/5 (poor exposure, disc tilt) 1/5 (poor position changed to fusion) ileus 1/17 0/4 2/5 Leg pain 2/17 Vascular injury

CONCLUSION TDR is a viable method to achieve reasonable patients satisfaction Complication is significantly higher than anticipated Multi-level is as good as single level for pain relief Multi-level has higher complication rate