Total lumbar disc replacement vs. lumbar fusion: 5 key notes on revision rates

Spine

A new study published in Spine examines complications and subsequent surgeries after lumbar total disc replacement and lumbar fusion.

The researchers examined the California Office of Statewide Health Planning and Development discharge database. Patients age 18 to 65 who underwent lumbar total disc replacement and lumbar fusion for degenerative disc disease from 2004 to 2010 were included in the study.

 

There were 52,877 patients included in the study. The researchers found:

 

1. Wound complications were more common after lumbar fusion — 1.3 percent — than disc arthroplasty — 0.25 percent.

 

2. The subsequent lumbar surgery 90 days after the primary surgery were lower with total disc replacement — 2.94 percent — compared with 4 percent for lumbar fusion.

 

3. One year after surgery, the revision rate for disc replacement was 3.46 percent, compared with 4.78 percent for lumbar fusion patients.

 

4. At three and five years after surgery, there were similar revision rates and subsequent surgery numbers between the two groups.

 

5. The researchers concluded, "Lumbar TDA may be associated with fewer acute infections, thought this may be approach-related and unrelated to the device itself."

 

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