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International Orthopaedics

Erschienen in:

01.02.2012 | Review Article

Infection and revision strategies in total disc arthroplasty

verfasst von: Antoine Gerometta, Juan Carlos Rodriguez Olaverri, Fabian Bittan

Erschienen in: International Orthopaedics | Ausgabe 2/2012

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Abstract

Purpose

Our aim was to revise the different strategies for treating an infected disc arthroplasty.

Methods

Despite recognition that disc replacement may reduce the incidence of adjacent-segment disease, the risk of potential complications associated with primary and revision total disc arthroplasty has diminished surgeon enthusiasm for the procedure. We performed a literature review of the different revision strategies for an infected disc arthroplasty.

Results

The need for revision of lumbar total disc arthroplasty has been reported in a number of prospective, randomised trials (level I or II evidence). Suboptimal patient selection and/or surgical technique accounted for the majority of failed disc arthroplasties. Revision procedures include posterior stabilisation or anterior extraction and conversion to arthrodesis. The risk of injury to the great vessels and retroperitoneal structures is greater during revision than primary procedures. The use of a distant lateral, or transpsoas, approach to the anterior column may reduce these adverse events. Also, the use of adhesion barriers has been shown to reduce adhesions in abdominal and pelvic surgery and may be of benefit in revision disc arthroplasty.

Conclusion

This review article provides an update on the various treatments for infected lumbar disc prosthesis and the different surgical approaches used in these difficult cases. It also describes potential options to avoid complications associated with the revision surgical approach.

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Titel: Infection and revision strategies in total disc arthroplasty
verfasst von: Antoine Gerometta
Juan Carlos Rodriguez Olaverri
Fabian Bittan
Publikationsdatum: 01.02.2012
Verlag: Springer-Verlag
Erschienen in: International Orthopaedics / Ausgabe 2/2012
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-011-1436-y

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Abstract

Purpose

Methods

Results

Conclusion

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