Five-year registry results note reduced pain and increased quality of life following lumbar total disc replacement

[Justin]

Ortho SuperSite
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VIENNA — Key improvements were seen occurred in low back and leg pain levels through 2 years follow-up, Among 593 patients who received 679 total disc replacements and were followed for 5 years in the SWISSspine registry according to data reported at the 2010 Annual Congress of the Spine Society of Europe (EuroSpine 2010).

The SWISSspine registry is a mandatory data collection program for lumbar and cervical total disc replacement procedures in Switzerland.

Orthopaedic surgeon Thomas Zweig, MD, of the Institute for Evaluative Research in Orthopaedic Surgery at the University of Bern, Switzerland, which manages the SWISSspine registry, presented the findings to date with this prospective, multicenter observational case series.

“From a short-term or mid-term-perspective, lumbar total disc replacement appears to be a relatively safe and effective procedure for low back pain, as well as leg pain and improvement of quality of life. Nevertheless, predictions of wear and loosening and the other problems with arthroplasty cannot be measured,” he said.

Multicentered evaluation

For the cases reported, 46 surgeons at 32 sites each contributed from nine to 10 cases with data collected from forms the surgeons completed on procedures performed, implants used and follow-up examinations. Patient-reported data included North American Spine Society, EQ-5D quality of life, and comorbidity questionnaires.

At the 2-year follow-up, patient Visual Analog Scale scores changed from 70 to 27 points for low back pain and from 54 to 17 points for leg pain. “That is a real meaningful clinical change for pain,” Zweig said.

Quality of life also improved at the same follow-up time. Furthermore, patients reduced their use of pain medications following surgery. “Seventy percent used no pain medications at all at two years,” he said.

One or two levels

Complication rates were comparable in the one- and two-level cases, at approximately 8%.

During the paper’s discussion, Zweig noted, however, “Two-level surgery had a two-fold worse outcome for leg pain and back pain.”

Reference:
Zweig T, Aghayev E, Moulin P, et al. 5 years of experience with a national mandatory registry – Midterm results in 638 patients with 734 lumbar total disc arthroplasties (TDA). Paper #11. Presented at EuroSpine 2010. Sept. 15-17, 2010. Vienna.

[Gilbert P]

Thanks Justin

If two level had two fold worse outcome How am I going to do with four bad levels?

Life moves on

Gil

[Metalneck07]

Thanks Justin for the article. Please for give me but I'm a little confused on the statement " Two Level Surgery
had a two-fold worse outcome for leg pain and back pain." Thanks for any light you could shed on this.
Caitlin aka Metalneck07

[Justin]

Thanks Justin for the article. Please for give me but I'm a little confused on the statement " Two Level Surgery
had a two-fold worse outcome for leg pain and back pain." Thanks for any light you could shed on this.
Caitlin aka Metalneck07

During the paper’s discussion, Zweig noted, however, “Two-level surgery had a two-fold worse outcome for leg pain and back pain.”

Hi Caitlin,

This means that the spine patients that had a two-level artificial disc replacement surgery in this registry subjectively "rated" their leg and back pain through quality of life follow-up questionnaires as "twice as bad / two times worse" (two-fold) as compared to the single-level spine patients in the registry.

It's a little wordy, but I hope it makes sense.

[Metalneck07]

Thank you Justin for clarifying the statement.Very interesting !!
Caitlin aka Metalneck07