#492 Total Disc Replacement in the Treatment of Recurrent Lumbar Disc Herniation
Poster Presented by: N. Kang
N. Kang (1)
Y. Hai (1)
S.B. Lu (1)
(1) Beijing Chaoyang Hospital Affiliate Capital Medical University, Orthopeadic Department, Beijing, China
Objective: To evaluate Biomechanical benefits of Total Disc Replacement (TDR) including both the restoration of normal segmental range of motion and the prevention of physiological lumbar lordosis encourage spine surgeons to perform TDR for recurrent lumbar disc herniation.
Methods: A total of twenty first patients (mean age: 44) who had recurrent lumbar disc herniation were operated on between 2000 and 2008. Anterior lumbar discectomy with TDR placement via a extraperitoneal approach were performed. Each patient was evaluated using a VAS and the Oswestry index. Clinical and radiographic results of these patients were evaluated at each fallow-up time (1, 3, 6, 12, 24 months after operation and the latest).
Results: The average visual analogue scales score for pain was 9.40 before operation，changed to 4.30 one month after operation，further declined to 2.70 two years after operation and finally to 1.90 at the latest follow-up evaluation (P < 0.001). Meanwhile, the average Oswestry Disability Index was 50.8 before operation, 29.6 one month after operation, 13.5 two years after operation and 9.2 at the latest follow-up evaluation (P < 0.001). All operated levels maintained mobile and there was no significant loss of range of motion observed. Complications such as implant dislocation or significant subsidence of the prosthesis occurred in none case of this group. 96％ patients were satisfied with the surgery at the latest follow-up evaluation.
Conclusions: Results from this series are promising and indicate that placement of TDR for recurrent lumbar disc herniation is a valuable alternative to conventional techniques. The main advantages of this application are preservation of spinal stability, early mobilization, restoration of normal segmental range of motion and elimination of problems related to intervertebral disc tissue such as discogenic pain and recurrence of disc herniation.