Our Summary

This study aimed to understand the relationship between the rate of ‘implant subsidence’ (which is when an implanted device sinks into the bone) and the size of the implant in relation to the size of the adjacent bone. The researchers studied this in 104 patients who had undergone a specific type of spinal surgery.

They used two types of implants, one made of a material called PEEK and another coated in titanium. The patients were randomly assigned to receive one of these implants. The researchers then used CT scans to measure the size of the bone next to the implant and compared it to the size of the implant itself.

The researchers followed up with the patients for a year to see if there was any sinking of the implant into the bone. They found that 21% of the implants had sunk into the bone. Implants tended to sink more often when the bone was larger and the size of the implant compared to the bone was smaller.

However, the type of implant (whether it was PEEK or titanium-coated) didn’t significantly affect the rate of sinking. The researchers concluded that the size of the implant in relation to the size of the adjacent bone is an important factor in whether or not the implant is likely to sink.

FAQs

  1. What is ‘implant subsidence’ and how was it studied in this research?
  2. Did the material of the implant (PEEK or titanium-coated) have any impact on the rate of sinking?
  3. What was the key factor identified by the researchers that influenced whether or not an implant is likely to sink into the bone?

Doctor’s Tip

A helpful tip a doctor might give a patient about discectomy is to follow post-operative guidelines carefully to ensure proper healing and reduce the risk of complications. This may include avoiding heavy lifting or strenuous activities, practicing good posture, and attending physical therapy sessions as recommended. Additionally, maintaining a healthy weight and staying active can help support the healing process and prevent future spine issues.

Suitable For

Discectomy is typically recommended for patients with a herniated disc or degenerative disc disease that is causing severe pain, weakness, or numbness in the back, legs, or arms. Patients who have not found relief from conservative treatments such as physical therapy, medications, or epidural steroid injections may be recommended for discectomy surgery. Additionally, patients who have significant nerve compression, loss of bladder or bowel control, or progressive neurological deficits may also be candidates for discectomy to relieve pressure on the nerves.

Timeline

Before discectomy, a patient may experience symptoms such as back pain, leg pain, numbness, or weakness due to a herniated disc pressing on a nerve. The patient may undergo imaging tests such as an MRI to confirm the diagnosis.

After discectomy, the patient may experience immediate relief from their symptoms as the pressure on the nerve is relieved. The patient may have some pain and discomfort at the surgical site, but this typically improves over time. Physical therapy may be recommended to help with recovery and strengthen the muscles in the back. The patient will have follow-up appointments with their surgeon to monitor their progress and address any concerns.

What to Ask Your Doctor

  1. What is a discectomy and why is it being recommended for me?
  2. What are the potential risks and complications of a discectomy procedure?
  3. How long is the recovery time after a discectomy and what can I expect during the recovery process?
  4. Will I need physical therapy or rehabilitation after the discectomy?
  5. How likely is it that the implant used in the surgery may sink into the bone, based on my specific case?
  6. What factors contribute to the rate of implant subsidence, such as the size of the implant and the size of the adjacent bone?
  7. Are there any specific precautions or measures I can take to reduce the risk of implant subsidence?
  8. How will the sinking of the implant into the bone affect my long-term outcome and potential need for additional surgery?
  9. Are there any alternative treatment options to a discectomy that may have a lower risk of implant subsidence?
  10. What is the success rate of discectomy procedures in general, and how does the risk of implant subsidence factor into this success rate?

Reference

Authors: Godlewski B, Bebenek A, Dominiak M, Karpinski G, Cieslik P, Pawelczyk T. Journal: BMC Musculoskelet Disord. 2022 Aug 4;23(1):750. doi: 10.1186/s12891-022-05698-8. PMID: 35927645