A group of researchers examined lumbar total disc replacements using the Mobidisc and published their results in an issue of the Journal of Spinal Disorders & Techniques.
The researchers examined clinical and radiographic assessment of 21 levels for 18 consecutive patients' treatment with total lumbar disc replacement for degenerative disc disease. The researchers wanted to determine where there was a correlation between clinical and radiologic outcomes and prosthesis positioning.
"If the prosthesis positioning is poor, the facet joint loading is increased up to 2.5-fold," the study authors wrote. Here are five things to know about the study:
1. Around 77.8 percent of the patients were highly satisfied with their surgical outcome. Patients were followed for an average of 5.5 years after surgery. The patients were assigned to three groups based on their center of rotation index size. Texas Back Institute surgeons perform lumbar disc replacement, finding surgery taking approximately one hour to three hours and hospital stays lasting one day to two days.
2. The low back pain visual analogue scale scores decreased from 7.61±2.17 preoperatively to 2.33±2.679 at the last follow-up. A 2008 study examined the cost of lumbar spinal fusions and lumbar disc replacement. The study included 10 patients who underwent single-level fusion or disc replacement. The researchers found the actual cost of implants at the single institution included in the study for fusion when using rhBMP-2 and disc replacement were similar. Total hospital for anterior spinal fusion and posterior spinal fusion were significantly higher than TLIF, ASF or disc replacement.
3. Function increased postoperatively as well. The Oswestry Disability Index was 25.89±7.77 preoperatively compared to 5.89±7.21 at the last follow-up. A 2009 study presented at the American Academy of Orthopaedic Surgeons using the ProDisc-L found lumbar total disc replacement superior to fusion for DDD patients. The study included 237 patients at 16 centers and found 53.1 percent of the disc replacement patients had average ODI improvement of 34.4 points at 24 months, compared with 41.3 percent of the fusion patients, according to a Medscape report.
4. Radiographic findings showed total disc replacement improved disc space and segment height range of motion. In the 2009 study, there was no disc height loss in either group, but the artificial disc replacement patients had significantly lower reoperation rates.
5. The range of motion preservation decreased in all patients as the center of rotation increased. The FDA approved two artificial discs for lumbar disc replacement as of 2009: the Charite disc and ProDisc-L, according to a Spine-health report. Several other artificial discs are approved for cervical spine surgery, and LDR's Mobi-C is the only artificial disc to have clearance for one- and two-level cervical disc replacement.
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