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Related Experiment Video

Updated: Feb 19, 2026

A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations
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Lumbar total disc replacement: predictors for long-term outcome.

Håvard Furunes1,2,3, Christian Hellum4, Jens Ivar Brox5,6

  • 1Department of Surgery, Innlandet Hospital Gjøvik, Kyrre Grepps Gate 11, 2819, Gjøvik, Norway. havardfurunes@gmail.com.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|November 6, 2017
PubMed

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Summary

Patient characteristics like Modic changes predict better outcomes after lumbar total disc replacement (TDR). Factors such as comorbidity and education level influence long-term employment post-TDR surgery.

Area of Science:

  • Spine surgery outcomes research
  • Biomechanical engineering
  • Patient-reported outcome measures

Background:

  • Chronic low back pain (LBP) significantly impacts patient quality of life and work capacity.
  • Total disc replacement (TDR) is a surgical option for degenerative disc disease, but long-term outcome predictors require further investigation.
  • Identifying patient subgroups who benefit most from TDR is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To identify patient characteristics associated with favorable long-term functional improvement and employment after lumbar TDR.
  • To analyze baseline variables that predict clinical success 8 years post-TDR.
  • To understand factors influencing return to work after TDR for chronic LBP.

Main Methods:

Keywords:
Degenerative discLow back painLumbar total disc replacementPatient selection

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  • Analysis of a cohort of 82 patients with degenerative disc disease and LBP treated with TDR.
  • Assessment of baseline predictors and outcomes at 8-year follow-up, including Oswestry Disability Index (ODI) improvement (≥15 points) and employment status.
  • Logistic regression modeling to determine associations between baseline characteristics and long-term outcomes.

    • Main Results:

    • Patients with Modic changes (type 1 and/or 2) at baseline showed a statistically significant association with achieving a clinically important functional improvement (≥15 ODI points).
    • High probability of employment (87%) at 8-year follow-up was observed in patients with <1 year sick leave, no comorbidity, ODI <50, and higher education.
    • Low probability of employment (1%) was associated with ≥1 year sick leave, comorbidity, ODI ≥50, and ≤9 years of education.

    Conclusions:

    • Pre-operative Modic changes are a significant predictor of favorable functional outcomes following lumbar TDR.
    • Baseline factors including comorbidity, education level, duration of sick leave, and baseline ODI score are strongly associated with long-term employment status after TDR.
    • These findings can aid in patient selection and expectation management for lumbar TDR.