Results of lumbar total disc arthroplasty in military personnel
| Autor: | Mitchell Hardenbrook, Julio Petilon, Jonathan Roth |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Arthrodesis Physical fitness Intervertebral Disc Degeneration Hospitals Military Degenerative disc disease Arthroplasty Prosthesis Implantation Disability Evaluation Young Adult Lumbar Outcome Assessment Health Care medicine Humans Orthopedics and Sports Medicine Arthroplasty Replacement Retrospective Studies business.industry Retrospective cohort study Prostheses and Implants Middle Aged medicine.disease Surgery Oswestry Disability Index Radiography Military Personnel Treatment Outcome Female Neurology (clinical) Spondylosis business Range of motion Diskectomy Follow-Up Studies |
| Zdroj: | Journal of spinal disorderstechniques. 24(5) |
| ISSN: | 1539-2465 |
| Popis: | STUDY DESIGN Evaluation of lumbar total disc arthroplasty (TDA) in military patients. OBJECTIVE To evaluate the clinical and radiographic outcomes of US military personnel who have undergone TDA for degenerative disc disease and to assess the retention versus discharge rate after undergoing this procedure. SUMMARY OF BACKGROUND DATA TDA was developed as an alternative to arthrodesis for the surgical management of degenerative disc disease with the goal of preserving motion and reducing adjacent segment disease. However, the indications and optimal candidates for this procedure are uncertain. Military members must maintain a certain level of physical fitness and be capable of meeting the demands of hazardous environments. This study reviews results of TDA performed on active duty military members. METHODS The surgery schedules from 2005 to 2008 were reviewed to identify military members who underwent single-level or 2-level TDA for degenerative disc disease after failing at least 6 months of conservative management. All patients had a minimum of 2-year follow-up. Preoperative and postoperative clinical assessments were completed using the Oswestry Disability Index (ODI) questionnaire and the numeric rating scale (NRS). Radiographs were evaluated to determine range of motion, height, and disc position at the operated levels. The retention rate of the patients in the military was also recorded. Statistical analysis of the data was carried out with significance assumed at the P < 0.05 level. RESULTS Thirty-eight patients, implanted with a total of 56 discs, met the criteria for retrospective analysis. Twenty patients had single-level and 18 had 2-level TDA. Mean age was 35 (23 to 56 y) years. Mean follow-up was 28 months. The overall mean preoperative ODI and NRS of 53.6 and 7.3, significantly improved postoperatively to 27.7 and 3.3, respectively (P < 0.001). There was no difference in the postoperative ODI (P = 0.19) or NRS (P = 0.18) when comparing single-level and 2-level TDA. Clinical success was achieved in 79% of patients. Mean range of motion was 6.5 degrees and the mean disc height increased by 69%. Sixty-eight percent of patients returned to full active duty. CONCLUSIONS This study showed clinical success approaching 80% in military patients who underwent lumbar TDA. Furthermore, close to 70% were able to return to their positions within the military. TDA, while more closely reapproximating the normal biomechanics of the spine, may provide patients with an improved alternative to spinal arthrodesis for degenerative disc disease. |
| Databáze: | OpenAIRE |
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