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Challenges and Solutions for Lumbar Total Disc Replacement Implantation
Michael Janssen1, Rolando Garcia2, Lynn Miller3
1Center for Spinal Disorders, Thornton, CO.
Spine
|November 28, 2017
Summary
Long-term data confirm lumbar total disc replacement (TDR) is safe and effective, showing risks comparable or lower than fusion. Lumbar TDR may reduce adjacent segment degeneration and reoperations, with minimal late complications.
Area of Science:
- Orthopedics
- Spinal Surgery
- Biomedical Engineering
Background:
- Long-term safety and efficacy data for lumbar total disc replacement (TDR) are now available.
- Previous studies suggested comparable or lower complication risks for TDR versus spinal fusion.
Purpose of the Study:
- To evaluate the long-term safety and efficacy of lumbar total disc replacement (TDR).
- To compare the risk of complications, adjacent segment degeneration, and reoperations between lumbar TDR and spinal fusion.
Main Methods:
- Review of five-year randomized controlled trials, meta-analyses, and observational studies.
- Analysis of published data on commercially available lumbar TDR devices.
- Inclusion of survey results from surgeon practice experiences.
Main Results:
- Lumbar TDR demonstrates a similar or lower risk of complications compared to spinal fusion.
- Published data show minimal concerns regarding late-onset complications with lumbar TDR.
- Lumbar TDR may reduce the risk of adjacent segment degeneration and reoperations versus fusion.
Conclusions:
- Long-term data support the safety and efficacy of lumbar TDR.
- Lumbar TDR offers potential advantages over fusion in reducing adjacent segment degeneration and reoperations.
- Adherence to patient selection criteria is crucial for minimizing complications in lumbar TDR procedures.
