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Chronic Low Back Pain

History of Nucleus Replacement

The History of Nucleus Replacement - Part I


Historically the first human implanted nucleus prothesis was the Fernström Ball in 1966 (spherical endoprothesis from stainless steel) It was meant as a spacer allowing movement between adjacent vertebral bodies.


Challenges: It was abandoned as concern rose about migration & subsidence.


Early Attempts

Other early attempts often included free injections of substances (polymers, liquids or gels) into the nucleus with the idea that filler would stabilize the degenerated state and support weight.


Challenges:  Often resulted in expulsions or dislocations of the substances. These drawbacks led to the development of contained or enclosed designs placed into the disc after the complete nucleus was removed.


The History of Nucleus Replacement - Part II

1962 - 2009

Early nucleus replacement devices incorporated elastomeric materials (hydrogels & non-hydrogels), mechanical devices and tissue-engineered implants.


Elastomeric designs

                                                                          in situ-formed

Advantages In situ-formed implants had better implant conformity, better stress distribution, implant stability and smaller annular opening reducing risk of expulsion.

Challenges Material fatigue, biocompatibility and leakage of injectables through annular opening.

2010 -

The next design steps, therefore, included inflatable balloons as injectable, in situ-formed devices which allowed for altering of the device shape during implantation as well as for a small annular opening.


Among the pioneers for next step design, Spinal Stabilization Technologies maybe on to something revolutionary… an alternative surgical treatment option with the potential of being both more flexible and less invasive: The PerQdisc™ Nucleus Replacement System.


The PerQdisc Nucleus Replacement offers an anatomical and biomechanical, motion-preserving, surgical alternative to fusion and total disc replacement. The PerQdisc replaces the physical space of the nucleus, in an effort to recreate normal, stable physiological motion, redistribute the weight bearing forces and mechanical properties of the disc in a more natural fashion and preserve disc height.


The PerQdisc surgical technique requires a small dilation into the annulus fibrosus, which facilitates access and removal of the nucleus, allowing for a focused area of attention with minimal damage to surrounding tissue. 


The PerQdisc technology provides a patient-specific, form-fitting, custom implant, unique to each individual patient.

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