Abstract
Total disc prostheses were introduced as an alternative to spinal fusion, the treatment goal being provision of not only relief from pain but also retention or restoration of motion, similar to that seen in other joint replacement surgery. Indeed, early designs were developed using the same materials and biomechanical principles as in hip and knee prostheses, implying that such devices involve the possible risks of wear-induced failure. As these devices reach medium-term implantation, cases of osteolysis and wear-related failure begin to emerge. It is therefore essential that wear is considered in the development of total disc prostheses. The complex biomechanics and differing environment of the spine create additional complications when modeling wear behavior and the effects that it may have on the body. This chapter provides a brief introduction to the anatomy and biomechanics of the spine and the degenerated disc, and the surgical considerations for total disc prostheses. The design of these devices is discussed, including key considerations of material selection, constraint, and wear. Wear simulation, including current international standards and simulators in use, and the wear of metal-polyethylene, metal-metal, and alternative bearing materials are examined in detail. Finally, the biological response to wear debris, specifically in the spine, is considered.
Original language | English |
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Title of host publication | Comprehensive Biomaterials II |
Publisher | Elsevier Korea |
Pages | 246-264 |
Number of pages | 19 |
ISBN (Electronic) | 9780081006924 |
ISBN (Print) | 9780081006917 |
DOIs | |
Publication status | Published - 1 Jan 2017 |
Bibliographical note
Publisher Copyright:© 2017 Elsevier Ltd.
Keywords
- Degenerative disc disease
- Intervertebral disc
- Polyethylene
- Total disc prosthesis
- Total disc replacement
- Wear
ASJC Scopus subject areas
- General Engineering
- General Materials Science