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Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability
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Total Disc Replacement in Lumbar Degenerative Disc Diseases
1Department of Neurosurgery, The Catholic University of Korea College of Medicine, Seoul, Korea. ; Good Doctor Teun Teun Hospital, Anyang, Korea.
Journal of Korean Neurosurgical Society
|December 30, 2015
Summary
Lumbar total disc replacement (LTDR) shows comparable outcomes to fusion for degenerative disc disease, but requires longer follow-up to assess new potential complications and long-term benefits.
Area of Science:
- Spine surgery
- Orthopedic research
- Biomaterials in medicine
Background:
- Lumbar degenerative disc disease (DDD) management remains controversial.
- Spinal fusion is the gold standard but has limitations.
- Lumbar total disc replacement (LTDR) emerged as a potential alternative.
Purpose of the Study:
- To evaluate the current status and future direction of LTDR.
- To compare LTDR outcomes with traditional fusion.
- To identify the benefits and risks of LTDR.
Main Methods:
- Review of prospective randomized controlled studies with >5-year follow-up.
- Analysis of USA IDE trials comparing LTDR and fusion.
- Assessment of clinical studies on LTDR efficacy and complications.
Main Results:
- LTDR is not inferior to fusion for lumbar degenerative disc disease.
- No strong evidence shows LTDR prevents adjacent segment disease.
- LTDR avoids fusion's shortcomings but introduces new potential complications.
Conclusions:
- Longer follow-up is necessary to confirm sustained outcomes and late complications of LTDR.
- LTDR has potential as a fusion substitute if safety and efficacy concerns are addressed.
- Further research needed to establish LTDR's long-term value in spine surgery.
