Study questions effect of disc replacement on low back pain

January 8, 2013
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."

Explore further: Artificial disc a viable alternative to fusion for 2-level disc disease

More information: Full Text

Related Stories

Pattern of disc degeneration impacts low back pain

April 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 to a study published ...

Good stability with artificial disc plus cage fusion

August 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 to research ...

Disc disease severity doesn't predict surgical outcomes

November 9, 2012

(HealthDay)—Increasing severity of degenerative disc disease (DDD) does not impact outcomes in total lumbar disc replacement (TDR), according to a study published in the November issue of the European Spine Journal.

Review compares surgeries for sciatica due to herniated disc

November 10, 2012

(HealthDay)—No conclusions can be drawn with regard to the comparative efficacy of open, microscopic, and tubular discectomy surgical techniques to treat sciatica due to a herniated disc, according to the results of a systematic ...

Recommended for you

Cellphone data can track infectious diseases

August 20, 2015

Tracking mobile phone data is often associated with privacy issues, but these vast datasets could be the key to understanding how infectious diseases are spread seasonally, according to a study published in the Proceedings ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.