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NEW SURGICAL TECHNIQUE FOR IMPLANTATION OF PROSTHETIC DISC NUCLEUS DEVICES



Abstract

Objective: To determine the success of the Anterior Lateral transPsoatic Approach (ALPA) for implanting the PDN disc nucleus prosthesis.

Design: Eight patients were implanted with the PDN device via the ALPA technique. After making a 4cm incision in the lateral-abdominal area, the peritoneum was accessed and followed medially towards the lumbar spine, where a blunt-dissection technique through the psoas muscle was used to reach the disc. The anulus was then incised, and the nucleus material was removed before inserting the PDN device into the vacated disc cavity.

Subjects: Five female and three male patients, all with moderate degenerative disc disease, were implanted. Average age was 44.5 years (+/− 8.3). Seven patients were implanted at L4–L5 and one at L2–L3. These eight subjects were followed for twelve months.

Outcome measures: Improvements in Oswestry scores and disc-height measurements were considered indicative of implant success.

Results: Oswestry scores improved from a preoperative mean of 33.8 (+/− 15.1) to a postoperative mean of 10.0 (+/− 11.1), and disc height increased from a preoperative mean of 8.6mm (+/−2.4) to 9.4mm (+/− 2.3) postoperatively.

Conclusion: The ALPA technique facilitates implantation of the PDN device, with excellent clinical results.

Abstracts prepared by Mr. A. J. Stirling, FRCS, and Miss A. Weaver. Correspondence should be addressed to Miss A. Weaver at the Research and Teaching Centre, Royal Orthopaedic Hospital, Northfield, Birmingham, B31 2AP, UK

BritSpine 2002, the second combined meeting of the British Association of Spinal Surgeons, the British Cervical Spine Society, The British Scoliosis Society and the Society for Back Pain Research, took place at the International Convention Centre in Birmingham UK between 27th February and 1st March 2002. The following presentations and posters were given and displayed.