Lasting clinical results for total lumbar disc replacement

(HealthDay)—Total lumbar disc replacement (TDR) yields mid- to long-term clinical efficacy and patient satisfaction, according to a study published in the Aug. 1 issue of The Spine Journal.

Christoph J. Siepe, M.D., Ph.D., from the Teaching Hospital of the Paracelsus Medical University Salzburg, and colleagues assessed the mid- and long-term clinical efficacy of TDR in 181 patients over a mean follow-up of 7.4 years. Patients underwent surgery for the treatment of intractable and predominant (≥80 percent) axial low back pain resulting from degenerative disc disease.

The researchers found that at all postoperative follow-up stages there was a significant improvement from baseline visual analog scale (VAS) and Oswestry Disability Index levels (P < 0.0001). There was a slight, but significant decrease in VAS scores from 48 months onward. Throughout follow-up, satisfaction rates remained stable, with 63.6 percent of patients reporting a highly satisfactory or a satisfactory (22.7 percent) outcome, while 13.7 percent of patients were not satisfied. There was an overall complication rate of 14.4 percent, while the incidence of revision surgeries for general and/or device-related complications was 7.2 percent.

"In carefully selected cases, TDR can be considered a viable treatment alternative to lumbar fusion for which spine communities around the world seem to have accepted mediocre clinical results as well as obvious and significant drawbacks," the authors write.

Several researchers disclosed financial ties to the medical device industry.

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