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Related Experiment Videos

Total lumbar disc replacement: different results for different levels.

Christoph J Siepe1, H Michael Mayer, Matthias Heinz-Leisenheimer

  • 1Spine Center, OrthoCenter Munich, Munich, Germany. CSiepe@Schoen-Kliniken.de

Spine
|April 7, 2007
PubMed
Summary
This summary is machine-generated.

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Total lumbar disc replacement (TDR) outcomes depend on the disc level and number of implants. Monosegmental TDR at L4-L5 yields the best results, while bisegmental TDR shows higher complication rates and inferior outcomes.

Area of Science:

  • Spine surgery
  • Orthopedic surgery
  • Biomedical engineering

Background:

  • Multisegmental total lumbar disc replacement (TDR) is an off-label procedure lacking comparative effectiveness data against fusion.
  • Clinical trial results on monosegmental versus multisegmental TDR are conflicting.

Purpose of the Study:

  • To assess how the specific lumbar disc level and the number of discs replaced influence the midterm clinical outcomes of TDR.
  • To evaluate patient satisfaction and complication rates associated with different TDR configurations.

Main Methods:

  • Prospective study analyzing midterm clinical results of ProDisc II total lumbar disc replacement (TDR).
  • Outcome assessment included Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and clinical parameters.

Related Experiment Videos

  • Post-TDR pain patterns were investigated using fluoroscopically guided spine infiltrations.

    • Main Results:

    • All TDR groups showed significant improvement in VAS and ODI scores (P < 0.05).
    • Monosegmental TDR at L4-L5 achieved the highest patient satisfaction (90.9%) and best outcomes.
    • Bisegmental TDR at L4-L5 + L5-S1 resulted in significantly inferior outcomes and higher complication rates.

    Conclusions:

    • The lumbar disc level and number of TDRs significantly impact postoperative outcomes.
    • Monosegmental TDR at L4-L5 and L5-S1 provide satisfactory results, with L4-L5 TDR being optimal.
    • Bisegmental TDR is associated with increased complications and poorer results; postoperative facet/iliosacral joint pain is underestimated.