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Retrieval analysis of motion preserving spinal devices and periprosthetic tissues
Journal article   Open access

Retrieval analysis of motion preserving spinal devices and periprosthetic tissues

Steven M. Kurtz, Marla Steinbeck, Allyson Ianuzzi, André van Ooij, Ilona M. Punt, Jorge Isaza and E.R.S. Ross
SAS journal, v 3(4), pp 161-177
2009
DOI: https://doi.org/10.1016/j.esas.2009.11.003
PMID: 25802641
url
https://doi.org/10.1016/j.esas.2009.11.003View
Published, Version of Record (VoR)CC BY-NC-ND V4.0,  Open

Abstract

Artificial discs Chemical analysis Dynamic motion preservation Explant analysis Histology Mechanical testing Polyurethane Retrieval analysis UHMWPE Ultra-high molecular weight polyethylene Wear particles wear debris
This article reviews certain practical aspects of retrieval analysis for motion preserving spinal implants and periprosthetic tissues as an essential component of the overall revision strategy for these implants. At our institution, we established an international repository for motion-preserving spine implants in 2004. Our repository is currently open to all spine surgeons, and is intended to be inclusive of all cervical and lumbar implant designs such as artificial discs and posterior dynamic stabilization devices. Although a wide range of alternative materials is being investigated for nonfusion spine implants, many of the examples in this review are drawn from our existing repository of metal-on-polyethylene, metal-on-metal lumbar total disc replacements (TDRs), and polyurethane-based dynamic motion preservation devices. These devices are already approved or nearing approval for use in the United States, and hence are the most clinically relevant at the present time. This article summarizes the current literature on the retrieval analysis of these implants and concludes with recommendations for the development of new test methods that are based on the current state of knowledge of in vivo wear and damage mechanisms. Furthermore, the relevance and need to evaluate the surrounding tissue to obtain a complete understanding of the biological reaction to implant component corrosion and wear is reviewed.

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