The activL^® Artificial Disc: a next-generation motion-preserving implant for chronic lumbar discogenic pain

Figures & data

Figure 1 activL^® Artificial Disc.

Note: Top left, activL^® Artificial Disc. Disc components include spike cobalt chromium endplate with an ultra-high molecular weight polyethylene inlay; top right, implant assembly; bottom, implant insertion tool.

Figure 2 Footprint of the activL^® Artificial Disc standard (left) and S1 (right) inferior endplate.

Note: In comparison to the standard endplate, the S1 endplate has rounded posterior edges and can be placed close to the posterior rim of S1 without the endplate edges protruding into the spinal canal.

Table 1 Available configurations of activL^® Artificial Disc and ProDisc-L Total Disc Replacement

Device component	AP width (mm)		Lateral width (mm)		Angle (degrees)		Height (mm)
	activL^® Artificial Disc	ProDisc-L	activL^® Artificial Disc	ProDisc-L	activL^® Artificial Disc	ProDisc-L	activL^® Artificial Disc	ProDisc-L
Inferior endplate	26, 28,	27, 30	31, 34.5, 39, 40	34.5, 39	0, 5	0	–	–
Superior endplate	30, 33 26, 28, 30, 33	27, 30	31, 34.5, 39, 40	34.5, 39	6, 11	6, 11	–	–
Inlay	21	26, 29	21	23, 25	–	–	8.5, 10, 12, 14	10, 12, 14

Figure 3 Clinical and radiographic success rates in a randomized controlled trial comparing activL^® Artificial Disc to control total disc replacements (ProDisc-L or Charité).

Notes: Back pain success defined as improvement ≥20 mm. Oswestry Disability Index (ODI) success defined as improvement ≥15 points. Disc height success defined as increase >3 mm. Range of motion (ROM) success defined as change ≥−2° on flexion–extension radiographs.

Figure 4 Time to return to work in a randomized controlled trial comparing activL^® Artificial Disc to control total disc replacements (ProDisc-L or Charité).

Figure 5 Incidence of complications in a randomized controlled trial comparing activL^® Artificial Disc to control total disc replacements (ProDisc-L or Charité).

Abbreviations: DRAE, device-related adverse event; PRAE, procedure-related adverse event; SAE, serious adverse event; SDRE, serious device-related event.

Figure 6 Changes in back pain severity over 6-year mean follow-up with activL^® Artificial Disc versus ProDisc-L.

Abbreviation: VAS, visual analog scale.

Figure 7 Changes in Oswestry Disability Index over 6-year mean follow-up with activL^® Artificial Disc versus ProDisc-L.

Figure 8 Anterioposterior (left) and lateral (right) radiographs 7 years following implant with the activL^® Artificial Disc.

Figure 9 Comparison of 2-year back pain severity with activL^® Artificial Disc versus randomized controlled trial outcomes of lumbar total disc replacement (TDR) or fusion.

Notes: Each marker represents outcomes from a single study. Data from studies.^31–36

Figure 10 Comparison of 2-year Oswestry Disability Index (ODI) with activL^® Artificial Disc versus randomized controlled trial outcomes of lumbar total disc replacement (TDR) or fusion.

Notes: Each marker represents outcomes from a single study. Data from studies.^31–36

Figure 11 Comparison of 2-year reoperation rates with activL^® Artificial Disc versus randomized controlled trial outcomes of lumbar total disc replacement (TDR) or fusion.

Note: Each marker represents outcomes from a single study. Data from studies.^{31–33,35,36}

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