Prosthetic disc nucleus replacement for treatment of lumbar intervertebral disc herniation: a follow-up observation on 33 cases / 中国组织工程研究

ABSTRACT

BACKGROUND: Compared with artificial intervertebral disc replacement,prothetic nucleus replacement is easier to perform with fewer risks and requiting smaller incision.OBJECTIVE: To evaluate the effect of prosthetic disc nucleus replacement for treatment of lumbar disc herniation.DESIGN: A self-controlled trial.SETTING: Department of Orthopaedics, Zhujiang Hospital, Southern Medical University.PARTICIPANTS: Thirty-three patients including 21 male and 12 female patients with lumbar disc herniation received prosthetic disc nucleus replacement in Zhujiang Hospital of Southern Medical University from January 2002 to October 2003.METHODS: All the patients received prosthetic lumbar nucleus replacement and 3 weeks after the operation, X-ray examination was performed for observing the height and morphology of the intervertebral space. All the patients were followed up for 8 months and the therapeutic effects were assessed in a four-grade system(excellent, good, improved, poor). MAIN OUTCOME MEASURES: The change in the symptoms of low-back pain and the range of movement (ROM) of the lumbar spine.RESULTS: According to the intention-to-treat analysis, none of the 33 patients was lost to the analysis. During the follow-up, 29 patients had excellent, 3 good, and 1 poor outcome in terms of the symptoms of low-back pain and ROM of the lumbar spine, with a total rate of good outcome of 96. 97%(32/33) . X-ray examination in the 3rd month revealed normal size of the intervertebral space in 29 cases, and increased but still narrowed intervertebral space in 3 cases. No aggravation of retrograde changes was found in the adjacent segments.CONCLUSION: Prosthetic disc nucleus replacement can effectively relieve low-back pain in lumbar disc herniation, restore the spinal movement and decrease retrograde changes of adjacent intervertebral space and articular process.