1.26% of lumbar disc replacements needed revisions, Texas Back Institute surgeons find


Over 20 years, only 1.26% of lumbar disc replacements have needed a follow-up revision surgery or removal, spine surgeons at Texas Back Institute found.

Their research, published in the May 15 issue of Spine, looked at data from 2,141 lumbar disc replacements since 2000. Of the total patients, disc removal was done in 24 patients, and 12 patients needed revisions.

About 40% of removals and revisions happened in the first 25 total disc replacement cases done by individual surgeons. There was also a patient who had a "significant vascular complication" that was removed after trauma. 

Scott Blumenthal, MD, one of the investigators on the study, told Becker's that the study addresses the worry that lumbar disc replacement through the anterior approach could be dangerous.

"People were concerned when the technology first came out and they still use it to kind of create 'fake news' that these things come out and they need to be revised," Dr. Blumenthal said. "This is really the first paper that gives a numerator and a denominator in a large series. The perspective is number one, the removal and revision rate is quite low, and so that counteracts that discussion or that criticism. And it compares favorably to the hip and knee literature, which shows 5% to 10% revision rates over that same time period … That's the big take home message — it compares favorably to hip and knee replacements, and it's very infrequent."

Richard Guyer, MD; Jessica Shellock, MD; Jack Zigler, MD, and Donna Ohnmeiss, PhD, all part of TBI, are all listed as study investigators.

Dr. Blumenthal said he and his colleagues also examined revision rates in cervical disc replacements for a paper that was recently submitted for publication. In that study, they found the revision rate was about 1.4%.

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