Results of Lumbar Disc Replacement ImprovedLumbar disc replacements (LDRs) have been used in Europe for years. Long-term results are becoming available now. Results of previous short- to mid-term studies have been wide ranging. Studies will be ongoing until consistent results are reported.
In this study, data is presented on 108 patients with a single-level (L45 or L5S1) LDR. Each patient received an artificial disc and was followed for at least 10 years. Information was collected for some patients for as long as 16 years.
All patients in this study had back and leg pain from degenerative disc disease. Everyone was treated first with physical therapy and medication for at least six months. This is called conservative or nonoperative care. Despite treatment, painful symptoms persisted, so an artificial disc replaced the worn out disc.
Each patient received the same CharitÃ© disc device. A single surgeon implanted each one. Everyone was given the same rehab program after surgery. Results were measured using pain levels, work status, and X-rays. Any problems or complications after surgery were also reported.
Most (nearly 90 per cent) of the patients who worked before surgery went back to their former jobs. Patients who had sedentary jobs were more likely to return to work than those whose jobs involved hard labor.
A small number of patients had complications related to the disc replacement. About 10 per cent had to have the LDR removed and replaced or the spine fused. Overall success rate (good to excellent results) was 82 per cent. Only three per cent developed disc disease at the lumbar level next to the LDR segment. This rate is much lower than has been reported in other studies.
The author concludes LDR is safe and effective when used at one level of the lumbar spine. Many improvements over the years have made this possible. Surgical tools are better now. The implants have been changed in size, shape, and design. Knowledge and training programs are available today to help surgeons get better results faster and with fewer problems.
Thierry David, MD. Long-Term Results of One-Level Lumbar Arthroplasty. In Spine. March 15, 2007. Vol. 32. No. 6. Pp. 661-666.
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