A new study published in Clinical Spine Surgery examined five year outcomes for two-level lumbar disc replacements and compared the data with fusions.
Study authors examined data from 229 patients who either underwent two-level total disc replacement or spinal fusion; the patients were treated for degenerative disc disease between L3 and S1. The patients underwent a five-year follow up.
Here are the key findings:
1. The rate of adjacent segment disease was 3.5 percent of all patients, and 9.6 percent underwent secondary surgeries. Patients in the total disc replacement group were less likely to undergo a second surgery than the fusion group:
• 5.6 percent of disc replacement patients underwent a second surgery
• 19.1 percent of spinal fusion patients underwent a second surgery
2. Among patients who underwent secondary surgeries, 65 percent occurred at the index level, with those types of surgeries occurring in 16.2 percent of the fusion patients compared to 3.1 percent of the total disc replacement patients.
3. The reoperation rate in the adjacent level was the same between both fusion and disc replacement patients.
4. Instrumentation removal was the most common reason for index level reoperation; otherwise, there wasn't a significant difference between treatment at the index level or overall reoperations.
5. The study authors concluded total disc replacement is not an inferior procedure to fusion for two-level lumbar surgeries.