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Two-level lumbar total disc replacement: functional outcomes and segmental motion after 4 years
S Trincat1, G Edgard-Rosa2, G Geneste2
1Hôpital privé « les Franciscaines », 3, rue Jean-Bouin, 30032 Nîmes, France; 65, avenue Jean-Jaurès, 30900 Nîmes, France.
Orthopaedics & Traumatology, Surgery & Research : OTSR
|January 13, 2015
Summary
Two-level lumbar disc replacement enhances spinal function and mobility. However, the procedure carries risks and requires experienced surgeons, with ongoing evaluation needed for long-term outcomes.
Area of Science:
- Spine surgery
- Orthopedics
- Biomedical engineering
Background:
- Single-level lumbar total disc replacement is effective for discogenic lower back pain.
- Two-level lumbar disc replacement remains controversial despite potential benefits.
Purpose of the Study:
- To evaluate the efficacy and safety of two-level lumbar total disc replacement.
- To assess functional improvement and spinal motion preservation after the procedure.
Main Methods:
- Retrospective analysis of 108 patients undergoing two-level ProDisc-L replacement.
- Evaluation of functional outcomes using Oswestry scores and VAS scales.
- Assessment of spinal motion using Cobb's method with a 4-year average follow-up.
Main Results:
- Statistically significant improvement in functional scores was observed.
- Prosthetic disc segments showed preserved motion in flexion/extension and lateral bending.
- A complication rate of 18% was reported, with varying mobility at different spinal levels.
Conclusions:
- Two-level lumbar disc replacement can improve spinal function and mobility.
- The procedure is associated with risks and necessitates highly experienced surgical teams.
- Longer follow-up is required to assess long-term results and adjacent segment disease; the procedure is no longer recommended in France.
