Shim Chan Shik, Lee Seungcheol, Maeng Dae Hyun, Lee Sang-Ho
Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea.
J Spinal Disord Tech. 2005 Oct;18(5):465-9. doi: 10.1097/01.bsd.0000159035.35365.df.
As ProDisc has a tall keel on the plates, it has the potential to cause a vertical fracture of the vertebral body. However, to our knowledge, there is no previously reported case of a vertical split fracture of the vertebral body after ProDisc disc arthroplasty that was attributed to the keel design of the ProDisc. We report two cases of vertical split fracture of the vertebral body after total disc replacement (TDR) with ProDisc and discuss the issue of the height of the keel of the prosthesis. Even though there was no serious clinical consequence as a result of the fracture in our cases, except the fact that the patients were dissatisfied with the surgery at 3-month follow-up because of the prolonged back pain, the potential of the fracture to cause other serious complications such as hematoma, device migration, or surgical failure cannot be ignored. The keel design of the ProDisc has the disadvantage that it can cause a vertebral body fracture in some patients. Therefore, care should be exercised not to fracture the vertebral body when TDR is done with the ProDisc, especially in a patient with small vertebral body height or when it is done at multiple levels.
由于ProDisc在椎间融合器上有较高的龙骨，它有可能导致椎体垂直骨折。然而，据我们所知，以前没有报道过ProDisc椎间盘置换术后因ProDisc的龙骨设计导致椎体垂直劈裂骨折的病例。我们报告了两例使用ProDisc进行全椎间盘置换（TDR）后椎体垂直劈裂骨折的病例，并讨论了假体龙骨高度的问题。尽管在我们的病例中骨折没有导致严重的临床后果，除了患者在3个月随访时因背痛持续而对手术不满意外，骨折导致其他严重并发症如血肿、植入物移位或手术失败的可能性不能忽视。ProDisc的龙骨设计有一个缺点，即它可能在一些患者中导致椎体骨折。因此，在用ProDisc进行TDR时应小心操作，以免骨折椎体，特别是在椎体高度较小的患者中或在多个节段进行手术时。
