Clinical outcomes, radiologic kinematics, and effects on sagittal balance of the 6 df LP-ESP lumbar disc prosthesis
TypeArticles dans des revues avec comité de lecture
Background context: Surgical treatment of degenerative disc disease remains a controversial subject. Lumbar fusion has been associated with a potential risk of segmental junctional disease and sagittal balance misalignment. Motion preservation devices have been developed as an alternative to fusion. The LP-ESP disc is a one-piece deformable device achieving 6 df, including shock absorption and elastic return. This is the first clinical report on its use. Purpose: To assess clinical outcomes and radiologic kinematics in the first 2 years after implantation. Study design: Prospective cohort of patients with LP-ESP total disc replacement (TDR) at the lumbar spine. Patient sample: Forty-six consecutive patients. Outcome measures Clinical outcomes were the visual analog scale (VAS) for pain, the Oswestry disability index (ODI), and the GHQ28 (General Health Questionnaire) psychological score. Radiologic data were the range of motion (ROM), sagittal balance parameters, and mean center of rotation (MCR). Methods: Patients had single-level TDR at L4–L5 or L5–S1. Outcomes were prospectively recorded for 2 years (before and at 3, 6, 12, and 24 months after surgery). The SpineView software was used for computed analysis of the radiographic data. Paired t tests were used for statistical comparisons. Results: No intraoperative complication occurred. All clinical scores improved significantly at 24 months: the back pain VAS scores by a mean of 4.1 points and the ODI by 33 points. The average ROM of the instrumented level was 5.4°±4.8° at 2 years and more than 2° for 76% of prostheses. The MCR was in a physiological area in 73% of cases. The sagittal balance (pelvic tilt, sacral slope, and segmental lordosis) did not change significantly at any point of the follow-up. Conclusions: Results from the 2-year follow-up indicate that LP-ESP prosthesis recreates lumbar spine function similar to that of the healthy disc in terms of ROM, quality of movement, effect on sagittal balance, and absence of modification in the kinematics of the upper adjacent level.
Showing items related by title, author, creator and subject.
Total Hip Prostheses in Standing, Sitting and Squatting Positions: An Overview of Our 8 Years Practice Using the EOS Imaging Technology LAZENNEC, Jean-Yves; ROUSSEAU, Marc-Antoine; BRUSSON, Adrien; FOLINAIS, Dominique; AMEL, Maria; CLARKE, Ian; POUR, Aidin Eslam (Bentham Science Publishers, 2015)More total hip arthroplasty (THA) is performed worldwide and especially in younger and more active patients compared to earlier decades. One of the focuses of THA research in the future will be on optimizing the radiological ...
Offset and anteversion reconstruction after cemented and uncemented total hip arthroplasty: an evaluation with the low-dose EOS system comparing two- and three-dimensional imaging LAZENNEC, Jean-Yves; BRUSSON, Adrien; FOLINAIS, Dominique; ROUSSEAU, Marc-Antoine; POUR, Aidin Eslam (Springer, 2015)Purpose Accurate evaluation of femoral offset is difficult with conventional anteroposterior (AP) X-rays. The EOS imaging system is a system that makes the acquisition of simultaneous and orthogonal AP and lateral images ...
LAZENNEC, Jean-Yves; BRUSSON, Adrien; FOLINAIS, Dominique; ZHANG, A; POUR, Aidin Eslam; ROUSSEAU, Marc-Antoine (Springer, 2015)Introduction Sagittal balance of the coxofemoral joint in standing position and its extension capacity determine hip/spine adaptation, especially in relation to pelvic retroversion, which may be age-associated or follow ...
Do Patients’ Perceptions of Leg Length Correlate With Standing 2- and 3-Dimensional Radiographic Imaging? LAZENNEC, Jean-Yves; BRUSSON, Adrien; ROUSSEAU, Marc-Antoine; ROBBINS, Christopher B.; POUR, Aidin Eslam (Elsevier, 2016)BACKGROUND: This study compared 2- and 3-dimensional (2D and 3D) radiographic measurements of anatomical and functional leg length and knee coronal and sagittal alignments and correlated these measurements with patients' ...
The global alignment in patients with lumbar spinal stenosis: our experience using the EOS full-body images LAZENNEC, Jean-Yves; FOLINAIS, Dominique; BENDAYA, Samy; ROUSSEAU, Marc-Antoine; POUR, Aidin Eslam (Springer, 2016)Lumbar stenosis is frequently observed and treated by spine surgeons. The extent of neurological decompression and the potential spinal fixation are the basic concerns when surgery is planned. But this segmented approach ...