Total lumbar disc replacement in athletes: clinical results, return to sport and athletic performance

Despite the increasing popularity of total lumbar disc replacement (TDR) in predominantly young and active patients, no previous study has addressed possibilities, limitations and potential risks regarding athletic performance following TDR. Mechanical concerns remain and the implant’s resilience as regards its load-bearing capacity during sporting activities is unknown. Thirty-nine athletic patients fulfilled the inclusion criteria for this study. These patients participated in a large variety of different types of sport. Significant and lasting pain-relief was attained following TDR with a mean follow-up of 26.3 months (range 9–50.7 months; FU rate 97.4%). Sporting activity was resumed within the first 3 months (38.5%) to 6 months (30.7%) with peak performance being reached after 5.2 months. Thirty-seven patients (94.9%) achieved resumption of sporting activity. Athletic performance improved significantly in 33 patients (84.6%). Minor subsidence was observed in 13 patients (30%) within the first 3 months with no further implant migration thereafter in 12 patients. Participation in all types of sport recorded in this study was accessible for a high rate of patients up to the level of professional athletes as well as those participating in extreme sports. Preoperative participation in sport proved to be a strong positive predictor for highly satisfactory postoperative outcome following TDR. In a selected group of patients, however, preoperative inability to participate in sporting activities did not impair postoperative physical activity. Due to the young age of the patients and significant load increase exerted during athletic activities, persisting concerns regarding the future behaviour of the implant remain and will require longer follow-up, modified investigation techniques and larger patient cohorts

Preparations for deuterium-tritium experiments on the Tokamak Fusion Test Reactor

The final hardware modifications for tritium operation have been completed for the Tokamak Fusion Test Reactor (TFTR) [Fusion Technol. 21, 1324 (1992)]. These activities include preparation of the tritium gas handling system, installation of additional neutron shielding, conversion of the toroidal field coil cooling system from water to a Fluorinert™ system, modification of the vacuum system to handle tritium, preparation, and testing of the neutral beam system for tritium operation and a final deuterium-deuterium (D-D) run to simulate expected deuterium-tritium (D-T) operation. Testing of the tritium system with low concentration tritium has successfully begun. Simulation of trace and high power D-T experiments using D-D have been performed. The physics objectives of D-T operation are production of ≈ 10 MW of fusion power, evaluation of confinement, and heating in deuteriumtritium plasmas, evaluation of α-particle heating of electrons, and collective effects driven by alpha particles and testing of diagnostics for confined a particles. Experimental results and theoretical modeling in support of the D-T experiments are reviewed. © 1994 American Institute of Physics

Preparations for deuterium-tritium experiments on the Tokamak Fusion Test Reactor

The final hardware modifications for tritium operation have been completed for the Tokamak Fusion Test Reactor (TFTR) [Fusion Technol. 21, 1324 (1992)]. These activities include preparation of the tritium gas handling system, installation of additional neutron shielding, conversion of the toroidal field coil cooling system from water to a Fluorinert™ system, modification of the vacuum system to handle tritium, preparation, and testing of the neutral beam system for tritium operation and a final deuterium-deuterium (D-D) run to simulate expected deuterium-tritium (D-T) operation. Testing of the tritium system with low concentration tritium has successfully begun. Simulation of trace and high power D-T experiments using D-D have been performed. The physics objectives of D-T operation are production of ≈ 10 MW of fusion power, evaluation of confinement, and heating in deuteriumtritium plasmas, evaluation of α-particle heating of electrons, and collective effects driven by alpha particles and testing of diagnostics for confined a particles. Experimental results and theoretical modeling in support of the D-T experiments are reviewed. © 1994 American Institute of Physics