Clinical and Radiological Outcomes with the Lumbar Total Disc Replacements

ABSTRACT

OBJECTIVE: To determine the clinical and radiographic results and incidence of complications in lumbar arthroplasty patients. METHODS: From January, 2003 to March, 2005, 46 patients were implanted with 30 cases of the Charite Artificial Disc and 16 cases of the Prodisc. There were 28 males and 18 females with a mean age 40.6 years(range, 21~70). Diagnoses included 19 patients with discogenic back pain, and 27 patients with FBSS. All patients were examined at a minimum 2-year follow-up(mean 3.5 years). Clinical outcomes were assessed by Oswestry Disability lndex(ODI), Visual Analogue Scale(VAS),and Macnab's Criteria. Dynamic lateral flexion and extension radiographs were used to radiologic assessment. RESULTS: The ODI was reduced from 67.6% to 8.9% at the latest follow up. The mean VAS baseline was 8.29 and 2.08 at the latest follow-up. Clinical outcome was excellent or good in 40 patients(mean 87, 93% FBSS, 78% Discogenic back pain). Mean flexion/ extesion range of motion at L4-5 was 9.1degrees Charite, 9.8degrees Prodisc and at L5-S1 it were 5.5degrees, 5degrees. A total of 7 complications(15%) were noted [subsidence (2), polyethylene core wire break down (1), vertebral body posterior inferior cortex breakage (1), anhydrosis (2), nerve root damage (1)]. CONCLUSIONS: This study demonstrates the safety and efficacy of the total disc replacements especially FBSS cases.