Study questions effect of disc replacement on low back pain

Study questions effect of disc replacement on low back pain
Although total disc replacement for chronic low back pain due to degenerative disc disease yields statistically significant improvements compared to conventional fusion, the clinical relevance is unclear and conclusions regarding effectiveness are hampered by low quality evidence and short follow-up, according to a study published in the Jan. 1 issue of Spine.

(HealthDay)—Although total disc replacement for chronic low back pain due to degenerative disc disease yields statistically significant improvements compared to conventional fusion, the clinical relevance is unclear and conclusions regarding effectiveness are hampered by low quality evidence and short follow-up, according to a study published in the Jan. 1 issue of Spine.

Wilco C.H. Jacobs, from the Leiden University Medical Center in the Netherlands, and colleagues conducted a systematic literature review and identified seven , with a follow-up of 24 months, comparing total disc replacement with any other intervention for due to lumbar .

The researchers found that the included studies had a risk of bias due to sponsoring and lack of blinding. Despite not reaching the predefined threshold, one study that compared disc replacement with rehabilitation identified a significant advantage in favor of surgery. The quality of evidence was low in the six studies that compared disc replacement with fusion and showed a 5.2 mm higher mean improvement in the visual analog scale score of back pain. In five studies also with low quality of evidence, the improvement in the score at 24 months was 4.3 points more in the disc replacement group than in the fusion group. The upper bounds of the confidence intervals were below the predefined clinically relevant difference.

"Despite the publication of several recent studies on the effectiveness of total disc replacement, there is a strong need for high-quality studies, with less conflict of interest," the authors write. "Most important are long-term follow-up studies because differences in adjacent segment degeneration will be identified only then."

More information: Full Text

add to favorites email to friend print save as pdf

Related Stories

Good stability with artificial disc plus cage fusion

Aug 10, 2012

(HealthDay) -- For patients with multi-level cervical disc herniation, artificial cervical disc replacement and adjacent segment cage fusion achieves definite stabilization and satisfactory mobility, according ...

Pattern of disc degeneration impacts low back pain

Apr 12, 2012

(HealthDay) -- Contiguous, multilevel disc degeneration (CMDD) is associated with increased likelihood of low back pain (LBP) and pain severity compared with skipped level disc degeneration (SLDD), according ...

Recommended for you

Chikungunya fever identified in the United States

4 hours ago

(HealthDay)—Chikungunya fever is being seen in travelers returning to the United States from affected regions and should be considered as a diagnosis for febrile travelers, according to an ideas and opinions ...

Boost in quest for TB breath test

7 hours ago

A simple breath test may one day show whether someone has a strain of tuberculosis that will respond to a frontline antibiotic, or a drug-resistant type, scientists said Tuesday.

Three more dead from Legionnaire's disease in Spain

7 hours ago

Three more people have died from Legionnaire's disease in Catalonia in northeastern Spain, officials said Tuesday, bringing to seven the death toll from the lung infection in the region in just over a week.

User comments