Lumbar total disc arthroplasty: outdated surgery or here to stay procedure? A systematic review of current literature

Journal of Orthopaedics and Traumatology

Review Article

Andrea Zanirato¹  Luca Cavagnaro¹  Matteo Formica¹  Lamberto Felli¹  Stefano Divano¹  Marco Basso¹  Carlo Formica² 

[1] Clinica Ortopedica-IRCCS Azienda Ospedaliera Universitaria San Martino–IST, Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi, 10, 16132, GENOVA, GE, Italy;IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, MILAN, MI, Italy;

关键词: Total disc replacement;    Lumbar disc arthroplasty;    Degenerative disc disease;    Outcomes;    Complications;    Sagittal balance;   

DOI  :  10.1007/s10195-017-0462-y

 received in 2017-01-11, accepted in 2017-06-11,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe purpose of this study was to summarize the available evidence about total lumbar disc replacement (TDR), focusing our attention on four main topics: clinical and functional outcomes, comparison with fusion surgery results, rate of complications and influence on sagittal balance.Materials and methodsWe systematically searched Pubmed, Embase, Medline, Medscape, Google Scholar and Cochrane library databases in order to answer our four main research questions. Effective data were extracted after the assessment of methodological quality of the trials.ResultsFifty-nine pertinent papers were included. Clinical and functional scores show statistically significant improvements, and they last at all time points compared to baseline. The majority of the articles show there is no significant difference between TDR groups and fusion groups. The literature shows similar rates of complications between the two surgical procedures.ConclusionsTDR showed significant safety and efficacy, comparable to lumbar fusion. The major advantages of a lumbar TDR over fusion include maintenance of segmental motion and the restoration of the disc height, allowing patients to find their own spinal balance. Disc arthroplasty could be a reliable option in the treatment of degenerative disc disease in years to come.Level of evidenceII.

【 授权许可】

CC BY   
© The Author(s) 2017