Total disc replacement for lumbar degenerative disc disease: single centre 20 years experience

European spine journal

article

Carlo Formica¹  Andrea Zanirato²  Stefano Divano²  Marco Basso²  Luca Cavagnaro²  Mattia Alessio Mazzola²  Valerio Gaetano Vellone³  Maddalena Mastrogiacomo⁴  Pedro Berjano¹  Lamberto Felli²  Matteo Formica² 

[1] IRCCS Istituto Ortopedico Galeazzi;Clinica Ortopedica, Ospedale Policlinico San Martino;Department of Integrated Surgical and Diagnostic Sciences, University of Genoa - Ospedale Policlinico San Martino;Department of Internal Medicine, University of Genoa;Biotherapy Unit, Ospedale Policlinico San Martino

关键词: Degenerative disc disease;    Total disc replacement;    Long-term results;    Sagittal alignment;    Total disc arthroplasty;   

DOI  :  10.1007/s00586-019-06100-3

来源: Springer

【 摘 要 】

To report clinical and radiographic outcomes, rate of complications and influence on spinal alignment on long-term follow-up (FU) of patients who underwent lumbar total disc arthroplasty (TDR), bringing some evidence to determine the profile of the most well-suited patients for TDR. A retrospective review of patients underwent TDR for low back pain from degenerative disc disease (DDD) resistant to conservative treatment was performed. Demographic features, surgical data, clinical and radiographic outcomes, complications and spinopelvic parameters were evaluated. Thirty patients (32 TDR) were included with a mean FU of 164 ± 36.5 months. The clinical outcomes measured by visual analogue scale and Oswestry Disability Index showed a significant improvement between preoperative and 1-year FU (p  0.05). The surgical revision rate was 10%. The overall rate of complications was 20%. At final follow-up, the mobility of the prosthesis was preserved in 68.75% of the cases, and 73.3% of the patients were globally well aligned. The optimal surgical indication is crucial to achieve excellent clinical and radiological outcomes. According to the literature and to our experience, we underline the importance of a coronal deformity < 15° Cobb angle and a Roussouly type 1 or 2 as the profile of the most well-suited patient for TDR. Our long-term results confirm the existing evidence about efficacy and safety of TDR as a reliable option, in optimal surgery indication, to treat DDD. These slides can be retrieved under Electronic Supplementary Material.

【 授权许可】

Unknown