TY - JOUR
T1 - Normal and abnormal imaging findings in lumbar total disk replacement
T2 - Devices and complications
AU - Murtagh, Ryan D.
AU - Quencer, Robert M.
AU - Cohen, Dan S.
AU - Yue, James J.
AU - Sklar, Evelyn L.
PY - 2009/1/1
Y1 - 2009/1/1
N2 - Fusion, with or without laminectomy, is the standard treatment for symptomatic lumbar degenerative disk disease when conservative management has failed. Yet even radiographically verified solid fusion may be accompanied by considerable long-term problems, including recurrent low back pain, spinal stenosis, hypertrophic facet disease, pseudarthrosis, and spondylolysis and spondylolisthesis at adjacent levels. Several studies have shown a relationship between solid fusion and the development of adjacent-level disk disease, which is thought to result from increased stress on, or hypermobility of, adjacent seg-ments. Total disk replacement (TDR) was developed as a way to re-store normal mobility of the diseased segments and improve clinical outcomes by decreasing the risk of adjacent-level degenerative disease and related complications. However, like fusion, TDR is associated with various complications; some of these (eg, migration, subsidence) may occur regardless of the device used, whereas others (eg, extru-sion of the polyethylene inlay, vertical fractures) are device specific. Facet arthrosis, device wear, particle disease, adjacent-level degenera-tion, and heterotopic ossification also have been observed after TDR, but the frequency and importance of these findings remain uncertain. Given the increasing use of lumbar TDR to treat degenerative disk disease, it is important that radiologists be familiar with the most com-monly used devices and the potential complications of their use.
AB - Fusion, with or without laminectomy, is the standard treatment for symptomatic lumbar degenerative disk disease when conservative management has failed. Yet even radiographically verified solid fusion may be accompanied by considerable long-term problems, including recurrent low back pain, spinal stenosis, hypertrophic facet disease, pseudarthrosis, and spondylolysis and spondylolisthesis at adjacent levels. Several studies have shown a relationship between solid fusion and the development of adjacent-level disk disease, which is thought to result from increased stress on, or hypermobility of, adjacent seg-ments. Total disk replacement (TDR) was developed as a way to re-store normal mobility of the diseased segments and improve clinical outcomes by decreasing the risk of adjacent-level degenerative disease and related complications. However, like fusion, TDR is associated with various complications; some of these (eg, migration, subsidence) may occur regardless of the device used, whereas others (eg, extru-sion of the polyethylene inlay, vertical fractures) are device specific. Facet arthrosis, device wear, particle disease, adjacent-level degenera-tion, and heterotopic ossification also have been observed after TDR, but the frequency and importance of these findings remain uncertain. Given the increasing use of lumbar TDR to treat degenerative disk disease, it is important that radiologists be familiar with the most com-monly used devices and the potential complications of their use.
UR - http://www.scopus.com/inward/record.url?scp=63049107290&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=63049107290&partnerID=8YFLogxK
U2 - 10.1148/rg.291075740
DO - 10.1148/rg.291075740
M3 - Article
C2 - 19168839
AN - SCOPUS:63049107290
VL - 29
SP - 105
EP - 118
JO - Radiographics
JF - Radiographics
SN - 0271-5333
IS - 1
ER -