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Total disc replacement arthroplasty using the AcroFlex lumbar disc: a non-human primate model
Bryan W Cunningham1, Gary L Lowery, Hassan A Serhan
1Orthopedic Biomechanics Laboratory, Department of Orthopaedic Surgery, Union Memorial Hospital, 201 East University Pkwy, Baltimore, MD 21218, USA. bcspine@aol.com
Summary
The AcroFlex lumbar disc shows promising efficacy as an intervertebral disc prosthesis in baboons, demonstrating good bone ingrowth and stability. Biomechanical testing revealed preserved axial rotation but diminished bending motion over time.
Area of Science:
- Biomedical Engineering
- Orthopedic Surgery
- Regenerative Medicine
Background:
- Degenerative disc disease necessitates effective intervertebral disc prostheses.
- Evaluating novel prosthetics like the AcroFlex lumbar disc is crucial for advancing spinal surgery.
- Non-human primate models offer valuable insights into long-term implant performance.
Purpose of the Study:
- To assess the efficacy of the AcroFlex lumbar disc as an intervertebral disc prosthesis.
- To evaluate biomechanical, histopathologic, and histomorphometric outcomes of the AcroFlex implant.
- To establish a non-human primate model for total disc replacement arthroplasty research.
Main Methods:
- A randomized study involving 20 baboons comparing AcroFlex discs with iliac autografts.
- Surgical implantation at L3-L4 and L5-L6 lumbar levels.
- Post-mortem analyses included biomechanical flexibility testing, histopathology, and histomorphometry at 6 and 12 months.
Main Results:
- No significant systemic pathologic changes or implant loosening observed.
- AcroFlex demonstrated excellent bone ingrowth (54-57%) at the implant-bone interface.
- Biomechanical testing showed preserved axial rotation but reduced flexion/extension and lateral bending motion at 12 months.
Conclusions:
- The AcroFlex lumbar disc is a viable intervertebral disc prosthesis with good bone integration.
- While axial rotation is maintained, reduced bending motion may relate to implant contact area.
- This study establishes a robust model for evaluating total disc replacement arthroplasty in vivo.