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Related Concept Videos

Degenerative Disc Disease I: Introduction01:27

Degenerative Disc Disease I: Introduction

29
Degenerative disc disease is a chronic condition in which intervertebral discs gradually lose structure and function. It is not infectious or autoimmune; rather, it results from age-related biochemical and mechanical changes, influenced by genetic, metabolic, and environmental factors.Structure and Function of DiscsThe spine contains 23 intervertebral discs that absorb load, distribute forces, maintain spacing, and allow flexibility. Each disc consists of a nucleus pulposus, a gel-like core...
29
Degenerative Disc Disease ll: Pathophysiology01:23

Degenerative Disc Disease ll: Pathophysiology

30
The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...
30
Herniated Intervertebral Disc l: Introduction01:29

Herniated Intervertebral Disc l: Introduction

40
Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...
40

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Full-Endoscopic Transforaminal Approach for Lumbar Discectomy
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Total disc replacement.

J-M Vital1, L Boissière1

  • 1Unité Rachis 1, hôpital Tripode, CHU de Bordeaux, place Amélie Raba-Léon, 33000 Bordeaux, France.

Orthopaedics & Traumatology, Surgery & Research : OTSR
|January 14, 2014
PubMed
Summary
This summary is machine-generated.

Total disc replacement (TDR) offers comparable or faster short-term results than spinal fusion. However, long-term outcomes and complications like heterotopic ossification require further investigation for definitive advantages.

Keywords:
Cervical herniationCervical total disc replacement (CTDR)Cervicobrachial neuralgiaLow back painLumbar total disc replacement (LTDR)

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Area of Science:

  • Spine surgery
  • Biomechanical engineering
  • Orthopedic research

Background:

  • Total disc replacement (TDR) has been utilized in lumbar and cervical spine surgeries since the 1980s.
  • Indications differ: lumbar TDR for chronic low back pain, cervical TDR for soft disc herniation causing cervicobrachial neuralgia.
  • Both procedures involve an anterior approach, sharing similar biomechanical principles.

Purpose of the Study:

  • To review the current status and outcomes of total disc replacement (TDR) in spinal surgery.
  • To compare TDR with spinal fusion, focusing on efficacy and complications.
  • To highlight the importance of surgical technique and long-term follow-up.

Main Methods:

  • Review of numerous studies, including prospective randomized comparative trials.
  • Analysis of biomechanical concepts and surgical insertion techniques.
  • Evaluation of implant-related complications and adjacent segment degeneration.

Main Results:

  • TDR demonstrates non-inferiority to spinal fusion, with some studies showing short-term superiority in recovery speed.
  • The primary implant complication is heterotopic ossification, potentially reducing range of motion.
  • Adjacent segment degeneration rates are lower after TDR than after arthrodesis.

Conclusions:

  • TDR is a viable alternative to spinal fusion, offering comparable or improved short-term outcomes.
  • Long-term efficacy and the definitive advantage of TDR, especially in the cervical spine, require further extended follow-up.
  • Precise surgical technique is crucial, considering complex vascular anatomy, particularly in the lumbar region.