Long-term clinical outcome of the Charité III total lumbar disc replacement
| Autor: | L W van Rhijn, Martijn G. M. Schotanus, E M C Jutten, Paul C. Willems, J Kitzen, Nanne P. Kort, S.M.J. van Kuijk |
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| Přispěvatelé: | Orthopedie, RS: CAPHRI - R3 - Functioning, Participating and Rehabilitation, RS: CAPHRI - R6 - Promoting Health & Personalised Care, MUMC+: KIO Kemta (9), Epidemiologie, RS: CAPHRI - R2 - Creating Value-Based Health Care, MUMC+: MA Orthopedie (3), MUMC+: Centrum voor Bewegen (3), MUMC+: MA Orthopedie (9) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
SURGERY Joint Prosthesis medicine.medical_treatment Intervertebral Disc Degeneration 10-YEAR FOLLOW-UP DISEASE FUSION Medicine Orthopedics and Sports Medicine Intervertebral Disc Degenerative disc disease Pain Measurement Bone Transplantation Lumbar Vertebrae Clinical follow-up Femur Head Middle Aged DEGENERATION Prosthesis Failure Oswestry Disability Index Treatment Outcome medicine.anatomical_structure Lumbar spine ADJACENT Female Chronic Pain Adult Reoperation Total Disc Replacement medicine.medical_specialty Visual analogue scale Facet joint Young Adult Femoral head Ureter Humans RATES ARTHROPLASTY Device Removal business.industry FACET JOINT ARTIFICIAL DISC medicine.disease Arthroplasty Surgery Pseudarthrosis Spinal Fusion Spine arthroplasty Risk factors business Low Back Pain |
| Zdroj: | European Spine Journal, 29(7), 1527-1535. Springer, Cham |
| ISSN: | 0940-6719 |
| Popis: | Purpose To compare the long-term clinical results and complications of two revision strategies for patients with failed total disc replacements (TDRs). Methods In 19 patients, the TDR was removed and the intervertebral defect was filled with a femoral head bone strut graft. In addition, instrumented posterolateral fusion was performed (removal group). In 36 patients, only a posterolateral instrumented fusion was performed (fusion group). Visual analogue scale (VAS) for pain and Oswestry Disability Index (ODI) were completed pre- and post-revision surgery. Intra- and post-operative complications of both revision strategies were assessed. Results The median follow-up was 12.3 years (range 5.3–24.3). In both the removal and fusion group, a similar (p = 0.515 and p = 0419, respectively) but significant decrease in VAS- (p = 0.001 and p = 0.001, respectively) and ODI-score (p = 0.033 and p = 0.013, respectively) at post-revision surgery compared to pre-revision surgery was seen. A clinically relevant improvement in VAS- and ODI-score was found in 62.5% and 43.8% in the removal group and in 43.5% and 39.1% in the fusion group (p = 0.242 and p = 0.773, respectively). Removal of the TDR was associated with substantial intra-operative complications such as major vessel bleeding and ureter lesion. The percentage of late reoperations for complications such as pseudarthrosis was comparable for both revision strategies. Conclusions Revision of a failed TDR is clinically beneficial in about half of the patients. No clear benefits for additional TDR removal as compared to posterolateral instrumented fusion alone could be identified. Particularly, when considering the substantial risks and complications, great caution is warranted with removal of the TDR. Graphic abstract These slides can be retrieved under Electronic Supplementary Material. |
| Databáze: | OpenAIRE |
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