[Results of intersomatic arthrodeses in essential lumbalgia]

The results of 50 intersomatic arthrodeses, performed via an anterior approach, because of chronic, disabling low back pain with degenerative disc disease, was evaluated with a mean follow-up of 7 years (revision rate = 74.5 p. cent). Preoperative exploratory discography of the overlying and underlying vertebrae was systematic. The overall functional results evaluated according to an original quotation scale, show that only less than half of the patients who were operated upon are markedly improved at maximum follow-up. The clinical course of pain radiating to the lower extremities and associated with disabling lumbalgias, seems to be on a par with the course of lumbalgias and does not require a posterior surgical approach. Factors improving the success rates are an effective fusion (in first intention in 80 p. cent of the cases) and a healthy neo-joint from a discographic standpoint; factors that deteriorate the long-term success rate (and not short-term), essentially socio-professional ones (work related accidents). The contribution of the discographic data is emphasized: they anticipate the deterioration of the neo-joint discs, which, when present, causes most of the functional failures. Although these results are imperfect, arthrodesis (the authors remain faithful to the intersomatic arthrodesis), may not be completely excluded as treatment of essential disabling lumbalgias, resisting to medical and physiotherapeutic treatments.