Are lumbar disc replacements effective?
A new article published in Spine examines lumbar disc replacements performed with Activ L total disc replacement. The procedures were performed from March 2009 to March 2012. Patients were followed for an average of 28.8 months and had either mono- or bisegmental lumbar total disc replacement. There were 30 patients included in the study.
The researchers found:
1. There was an 86.7 percent success rate at the last follow-up with the Visual Analogue Scale score for low back and leg pain as well as Oswestry Disability Index scores significantly improved postoperatively.
2. The average intervertebral disc height three years after surgery was:
• Index segment: 12.87 mm
• Upper adjacent segment: 12.61 mm
• Lower adjacent segment: 11.62 mm
There wasn't any significant difference in these scores compared with the scores preoperatively.
3. There were no significant changes in range of motion at the lower adjacent segments.
4. The complications observed were:
• Iliac vein tears in two patients
• Prosthesis subsidence in three patients
• Heterotopic ossification in one patient
5. There were 18 patients who had returned to their original jobs at the final follow up. Another eight patients changed jobs while four patients stopped working.
"The one- to three-year follow-up of this cohort of patients showed satisfactory clinical outcomes," concluded the study authors. "The long-term results of Active L TDR need more investigation."