Journal of Capital Medical University ›› 2013, Vol. 34 ›› Issue (2): 264-269.doi: 10.3969/j.issn.1006-7795.2013.02.019

Previous Articles     Next Articles

Comparison of clinical effects of total lumbar disc replacement for different indications

WANG Yu, KONG Chao, LU Shibao, HAI Yong, WANG Qingyi, ZANG Lei, MENG Xianglong   

  1. Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
  • Received:2013-02-12 Online:2013-04-21 Published:2013-04-17
  • Supported by:

    This study was supported by Basic-clinic Fund of Capital Medical University(2007-2058).

Abstract:

Objective To retrospectively compare the clinical effects of total disc replacement for different indications. Methods From December 1999 to December 2006, 65 patients suffered from degenerative disc diseases were treated with Charite SB Ⅲ disc replacement. The patients were subdivided into 3 groups according to their diagnosis: 1 nine patients with discogenic low back pain; 2 thirty-five patients with degenerative disc disease(DDD), accompanying soft disc herniation(nucleus pulposus prolapse, NPP); 3 four patients with recurrence of NPP after disctomy. All patients were evaluated by VAS Score(0-100 pts) and ODI Score(%) pre-operatively and 1, 3, 6, 12, 24 months after surgery and at the final follow-up. Radiographic parameters as range of motion(ROM) of the index level were evaluated by A-P and dynamic X-Ray. Statistical calculations were conducted with the above data. Results Comparing results in each group: during the follow-ups, in the three groups significant differences were found in VAS Score and ODI Score compared with those before surgery; during the follow-ups, the ROM in three groups were well maintained and showed no significant difference with that before surgery. Compared results among groups: pre-operative VAS Score and ODI Score of patients with DDD accompanying NPP were higher than those of other two groups. At the final follow-up, there was no significant difference of VAS Score and ODI Score among three groups, but patients with DDD accompanying NPP had a better remission rate. During the follow-ups, the ROM in three groups were well maintained and showed no significant difference with that before surgery. At the final follow-up, there are no significant differences among the different groups. But patients with DDD accompanying NPP achieved better remission rate than the other two groups(P<0.05). There was no significant difference among the three groups pre-operatively and during the follow-ups. Conclusion Discogenic low back pain, DDD accompanying NPP and recurrence of NPP after disctomy are good indications for TDR. For patients with DDD accompanying NPP, TDR is an excellent choice.

Key words: lumbar spine, total disc replacement, clinical effects, indication

CLC Number: