Spine Surgery Unit, Polyclinique de Bois Bernard, Rouvroy, France.
Eur Spine J. 1993 Mar;1(4):254-9. doi: 10.1007/BF00298370.
Twenty-two patients with 29 lumbar disc prosthesis have been reviewed clinically and radiologically with a minimum of 12 months follow-up. The first operation in France with the SB Charity model was carried out in January 1989 with the help of the German authors Schellnäck and Büttner. The surgical technique consists of an anterior extraperitoneal approach with the patient in a supine and hyperlordotic position and must be very precise. The indications are very rare. At the moment, we only consider the prosthesis as an alternative to an arthrodesis in young patients with good-quality bone. We limit the indication to cases where fusion in situ is to be avoided: degenerative disease with collapsed disc, failed backs and instability at a maximum of one or two levels. The immediate results are encouraging, and no loosening of the prosthesis or osteolysis at the bone-prosthesis interface has been noticed in patients with 2 or more years follow-up. The segmental mobility still remains in bending and flexion/extension and is demonstrated by dynamic X-rays. Because we do not know the long-term results of implantation of the prosthesis, it must continue to be a rare procedure and the patient must be informed that in case of failure, fusion by a posterior or anterior approach may be necessary and is always possible.
22 例 29 个腰椎假体患者接受了临床和放射学随访，随访时间至少为 12 个月。1989 年 1 月，在德国作者 Schellnäck 和 Büttner 的帮助下，法国进行了首例 SB 慈善模型手术。手术技术包括仰卧位和过度前凸位的前路腹膜外入路，必须非常精确。适应证非常罕见。目前，我们仅将假体视为年轻、骨质量好的患者融合术的替代方法。我们将适应证限制在避免原位融合的情况下：伴有塌陷椎间盘、失败的背部和在 1 到 2 个水平最大的不稳定的退行性疾病。立即结果令人鼓舞，在随访 2 年或以上的患者中，未发现假体松动或骨假体界面处的骨溶解。节段性活动度仍然存在于弯曲和屈伸/伸展中，并通过动态 X 射线显示。由于我们不知道假体植入的长期结果，因此它必须继续是一种罕见的手术，并且必须告知患者，如果失败，可能需要通过后路或前路融合，并且总是可以进行。
