Nucleus replacement technologies

Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2007

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  • 1 Carolina Neurosurgery and Spine Associates, Charlotte, North Carolina; and
  • | 2 Department of Neurological Surgery, University of California, San Francisco, California
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✓ Nucleus replacement offers a less invasive alternative to traditional fusion or total disc replacement techniques in the treatment of symptomatic lumbar degenerative disc disease (DDD). The authors discuss the classification of nucleus replacement devices as well as their potential indications. The authors review the history and evolution of nucleus replacement devices emphasizing several that are actively in US Investigational Device Exemption pilot feasibility trials. Nucleus replacement devices can be functionally categorized as elastomeric and mechanical. A classification scheme is discussed. Nucleus replacement remains investigational, but early clinical results have been encouraging. Further clinical investigation with well-designed prospective, randomized pivotal trials is needed to determine the efficacy of nucleus replacement in the treatment of lumbar DDD, as well as its ideal indications.

Abbreviations used in this paper:

DDD = degenerative disc disease; LBP = low-back pain; MR = magnetic resonance; PDN = Prosthetic Disc Nucleus; PDR = partial disc replacement; PEEK = polyetheretherketone; TDR = total disc replacement.

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