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International study finds more than 90% survivorship at 5-years for artificial disc device

Investigators found statistically better 5-year predicted survivorship for total disc replacement vs. interbody fusion.

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AUSTIN, Texas — An international, multicenter study found a 93.1% average 5-year survivorship rate for total disc replacement performed using the Charité Artificial Disc from DePuy Spine.

Bryan W. Cunningham, MSc, and colleagues studied reoperation rates at the index vertebral level and at adjacent levels in 1,938 patients who received total disc replacement (TDR) using the Charité disc. Patients underwent surgery at eight spine centers and were followed for an average of 23 months.

Using revision, reoperation and implant removal to define failure, investigators predicted an average 5-year Kaplan-Meier survivorship of 93.1% at the index level and a 95.6% survivorship at adjacent levels, Cunningham said in presenting the study results to the North American Spine Society 22nd Annual Meeting, here.

"This is the first multicentered survivorship analysis [for the Charité disc]," he said.

Using a likelihood ratio chi-square test to examine the relationship between failure rates and postoperative intervals, the investigators also found that TDR patients were more likely to experience a failure within the first 2 years after surgery than in the later stages of postop recovery.

Investigators also compared survivorship rates between TDR patients and 58 patients who received anterior lumbar interbody fusion (ALIF) with Bagby and Kuslich (BAK) cages (Sulzer Medica). They found that TDR patients had statistically better 5-year predicted survivorship for both the index level and adjacent levels, Cunningham said.

The researchers also stratified Charité patients according to country: United States, Brazil, Australia, Korea and Belgium. They found that Korean patients had the highest 5-year predicted survivorship — 92% — and Brazilian patients had the lowest — 91.6%. However, the differences between countries did not reach statistical significance.

For more information:

• Bryan W. Cunningham, MSc, has indicated that he is a research consultant for DePuy.
• Cunningham BW, Demuth G, McAfee PC, et al. Survivorship analysis of the Charité Artificial Disc: Review of 1,938 patients from eight leading international spine centers. Paper #171. Presented at the North American Spine Society 22nd Annual Meeting. Oct. 23-27, 2007. Austin, Texas.