Please use this identifier to cite or link to this item: https://dora.health.qld.gov.au/qldresearchjspui/handle/1/1764
Title: Single-Level Total Disc Replacement: Mid- to Long-Term Outcomes
Authors: Scott-Young, Matthew 
McEntee, Laurence 
Rathbone, Evelyne 
Nielsen, David 
Grierson, Lauren 
Hing, Wayne 
Issue Date: 2022
Publisher: International Society for the Advancement of Spine Surgery
Source: Single-Level Total Disc Replacement: Mid- to Long-Term Outcomes Matthew Scott-Young, Laurence McEntee, Evelyne Rathbone, David Nielsen, Lauren Grierson, Wayne Hing International Journal of Spine Surgery Jul 2022, 8330; DOI: 10.14444/8330
Journal: International journal of spine surgery
Abstract: Total disc replacement (TDR) has been shown to be effective for the treatment of lumbar degenerative disc disease (DDD) in carefully selected patients. Previous studies have demonstrated high rates of patient satisfaction and improvement in patient-reported outcome measures (PROMs) compared with preoperative status but most have short-term follow-up or small cohort sizes only. The aim of this study is to report mid- to long-term PROMs from the treatment of symptomatic single-level lumbar DDD with TDR. Data collected prospectively concerning single-level TDR performed via an anterior approach were included for analysis. A preoperative assessment was obtained followed by postoperative follow-up assessments at 3, 6, and 12 months, and yearly follow-up thereafter. PROMs included patient satisfaction, visual analog score back and leg, Oswestry Disability Index, and Roland-Morris Disability Questionnaire. A total of 211 patients (118 men, 93 women) operated on between June 1997 and July 2015 were included in this study. Minimum follow-up was 4 years. The average age was 42.2 (range 24-87) years and median follow-up 96 interquartile range 72-132, range 48-120) months. The operative levels were L5-S1 (160, 75.8%) and L4-L5 (61, 24.2%). Both statistically and clinically significant improvements observed postoperatively were maintained at 10 years. In addition, 92% of patients reported either good (n = 29) or excellent satisfaction (n = 155) with treatment at final review. This study shows that single-level lumbar TDR used appropriately in selected patient results in clinically significant improvements in pain and function, well above the minimum clinically important difference, and good to excellent satisfaction in most patients. Further study to define long-term outcomes and survivorship is required. Statistically significant and clinically relevant improvements can be achieved by single-level lumbar TDR, in the treatment of single-level discogenic axial low back pain, with or without radiculopathy. These outcomes are sustained in the mid- to long-term followup periods.
Description: Cairns & Hinterland Hospital and Health Service (CHHHS) affiliated author: David Nielsen
DOI: 10.14444/8330
Keywords: degenerative disc disease;total disc arthroplasty;single level;total disc replacement;back pain;motion preservation;lumbar spine;long-term outcomes
Type: Article
Appears in Sites:Cairns & Hinterland HHS Publications

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