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

Autor: Pedro Berjano, Matteo Formica, Stefano Divano, Mattia Alessio Mazzola, Marco Basso, Maddalena Mastrogiacomo, Luca Cavagnaro, Carlo Formica, Lamberto Felli, Andrea Zanirato, Valerio Gaetano Vellone
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
Adolescent
Visual Analog Scale
Total disc arthroplasty
Visual analogue scale
medicine.medical_treatment
Intervertebral Disc Degeneration
Sagittal alignment
Prosthesis
Degenerative disc disease
Young Adult
03 medical and health sciences
0302 clinical medicine
Lumbar
Total disc replacement
medicine
Deformity
Humans
Orthopedics and Sports Medicine
Intervertebral Disc
Degenerative disc disease
Total disc replacement
Long-term results
Sagittal alignment
Total disc arthroplasty
Retrospective Studies
Long-term results
030222 orthopedics
Lumbar Vertebrae
Cobb angle
business.industry
Middle Aged
medicine.disease
Low back pain
Surgery
Oswestry Disability Index
Treatment Outcome
Female
medicine.symptom
business
Low Back Pain
030217 neurology & neurosurgery
Follow-Up Studies
Zdroj: European Spine Journal. 29:1518-1526
ISSN: 1432-0932
0940-6719
Popis: 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 0.01). No significant temporal variance has been identified between 1-year and long-term follow-up (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.
Databáze: OpenAIRE
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