The Journal of Bone and Joint Surgery (American). 2006;88:50-64.
doi:10.2106/JBJS.E.01066
© 2006 The Journal of Bone and Joint Surgery, Inc.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow [Video Supplement]
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Related articles in JBJS
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Tropiano, P.
Right arrow Articles by Marnay, T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Tropiano, P.
Right arrow Articles by Marnay, T.
Related Collections
Right arrow Surgical Techniques
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?

Lumbar Total Disc Replacement

Patrick Tropiano, MD1, Russel C. Huang, MD2, Federico P. Girardi, MD3, Frank P. Cammisa, Jr., MD3 and Thierry Marnay, MD4

1 Department of Orthopaedic Surgery, Hôpital CHU Nord, Chemin des Bourrelly, 13915 Marseille CEDEX 20, France. E-mail address: ptropiano{at}ap-hm.fr
2 The Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021. E-mail address for R.C. Huang: russelhuang{at}yahoo.com
3 The Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021.
4 Department of Orthopaedic Surgery, Clinique du Parc, 50 Rue Emile-Combes, Boite Postal 20, 34171 Castelnau-le-Lez, France

Investigation performed at the Department of Orthopaedic Surgery, Clinique du Parc, Castelnau-le-Lez, France

The original scientific article in which the surgical technique was presented was published in JBJS Vol. 87-A, pp. 490-496, March 2005

In support of their research for or preparation of this manuscript, one or more of the authors received grants or outside funding from the Synthes Company. In addition, one or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity (Synthes Company). Also, a commercial entity (Purdey education program) paid or directed, or agreed to pay or direct, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which one or more of the authors are affiliated or associated.

The line drawings in this article are the work of Joanne Haderer Müller of Haderer & Müller (biomedart{at}haderermuller.com).

BACKGROUND: Symptomatic lumbar degenerative disc disease is a challenging entity to treat. The results of arthrodesis may be compromised in the short term by pseudarthrosis and in the long term by pain at the iliac-crest donor site and by junctional degeneration. Total disc replacement has the potential to provide long-lasting relief to these patients. The purpose of this study was to present the clinical and radiographic results assessed seven to eleven years following a Prodisc total lumbar disc replacement.

METHODS: Sixty-four patients had single or multiple-level implantation of a total lumbar disc replacement between 1990 and 1993. The mean duration of follow-up was 8.7 years. Clinical results were evaluated by assessing preoperative and postoperative lumbar pain, radiculopathy, disability, and modified Stauffer-Coventry scores. Preoperative and post-operative radiographs were evaluated by assessing preoperative and postoperative lumbar pain, radiculopathy, disability, and modified Stauffer-Coventry scores. Preoperative and post-operative radiographs were evaluated as well. Subgroup analysis was performed to determine if gender, an age of less than forty-five years, previous surgery, or multilevel surgery had an effect on outcome.

RESULTS: At an average of 8.7 years post-operatively, there were significant improvements in the backpain, radiculopathy, disability, and modified Stauffer-Coventry scores. Thirty-three of the fifty-five patients with sufficient follow-up had an excellent result, eight had a good result, and fourteen had a poor result. Neither gender nor multilevel surgery affected outcome. An age of less than forty-five years and prior lumbar surgery had small but significant negative effects on outcome. Radiographs did not demonstrate loosening, migration, or mechanical failure in any patient. Five patients had approach-related complications.

CONCLUSIONS: The Prodisc lumbar total disc replacement appears to be effective and safe for the treatment of symptomatic degenerative disc disease. Gender and multilevel surgery did not affect the outcomes, whereas prior lumbar surgery or an age of less than forty-five years was associated with slightly worse outcomes. Longer follow-up of this cohort of patients and randomized trials comparing disc replacement with arthrodesis are needed.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?

Related articles in JBJS:

Lumbar Total Disc Replacement. Seven to Eleven-Year Follow-Up
Patrick Tropiano, Russel C. Huang, Federico P. Girardi, Frank P. Cammisa, Jr., and Thierry Marnay
JBJS 2005 87: 490-496. [Abstract] [Full Text]