Article
Clinical results of endoprothetic disc replacement in the lumbar spine after Prodisc implantation: correlation of clinical outcome and different indications
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Published: | June 13, 2005 |
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Outline
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Introduction
Despite increasing popularity of disc arthroplasty for degenerative disc disease treatment, indications remain a matter of debate. We report the results of disc-arthroplasty using ProdiscTM for different indications, minimum follow-up 12 months.
Materials and Methods
Between 07/2000 and 12/2004, the ProdiscTM-device was implanted in 165 patients (43,5 years avg.) mono-, bi- or multi-segmentally. Indications included degenerative disc disease with (Modic) and without Modic-changes (DDD), DDD with disc herniation, postoperative osteochondrosis, adjacent disc degeneration following previous fusion, DDD with a monosegmental tilt and combined fusion-disc-replacement procedures in adjacent levels. Diagnosis were based on x-ray/ MRI-imaging. Results were evaluated according to VAS, SF-36 and Oswestry-Disability-Questionnaire (ODQ). Examinations were carried out 3, 6, 12 months postoperatively, annually from then.
Results
DDD: VASpre= 6,7; ODQpre 41%; VASpost=3,4 and 21% ODQpost. DDD+NPP: VASpre = 6,3; ODQpre 34%; postoperative VASpost=1,6 and 9% ODQpost. KOMBI: VASpre = 8,1; ODQpre 46%; VASpost =3,3 and 18% ODQpost. MODIC: VASpre = 7,0; ODQpre= 40, VASpost = 2,8; ODQpost = 16. DDD postop: VASpre= 7,0; ODQpre 44%; VASpost=3,6 and 28% ODQpost. Average duration of operation 126 min/monosegmental operations; blood loss approx. 100ml/segment. Peri-/postoperative complications: 1 inlay dislocation, 1 temporary retrograde ejaculation, 1 common iliac vein thrombosis. Within < 12 months 78% of patients had returned to their occupations.
Conclusion
Whilst longer follow-up evaluations are necessary, present data suggest that total disc arthroplasty is a safe and standardized procedure for treatment of DDD with good postoperative clinical results. Due to significantly varying outcomes, indications for disc arthroplasty must be defined precisely.