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Lumbar disc arthroplasty: a critical review
Daniel K Resnick1, William C Watters
1Department of Neurosurery, University of Wisconsin School of Medicine, Madison, Wisconsin, USA.
Clinical Neurosurgery
|May 29, 2008
Summary
Lumbar disc arthroplasty offers motion preservation but lacks evidence of superior outcomes compared to fusion. Further long-term studies are needed to justify costs and potential complications.
Area of Science:
- Spinal Surgery
- Orthopedic Devices
Background:
- Lumbar disc arthroplasty is a novel spinal surgery development.
- Proponents claim motion preservation reduces adjacent segment disease and improves long-term outcomes.
Purpose of the Study:
- To evaluate the efficacy of lumbar disc arthroplasty compared to lumbar fusion.
- To assess the evidence supporting motion preservation benefits and adjacent segment disease hypothesis.
Main Methods:
- Comparative analysis of lumbar disc arthroplasty versus lumbar fusion.
- Review of current evidence on functional outcomes, costs, and complications.
Main Results:
- No current evidence supports superior short- or long-term functional outcomes for disc arthroplasty over fusion.
- Limited evidence exists for adjacent segment degeneration as a significant clinical issue.
Conclusions:
- Lumbar disc arthroplasty's higher costs and complication risks are not yet justified by demonstrated efficacy.
- Widespread adoption requires further rigorous, long-term studies in controlled settings.
