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Review
. 2024 Jul;14(6):1827-1837.
doi: 10.1177/21925682241228756. Epub 2024 Jan 23.

Lumbar Total Disc Replacements for Degenerative Disc Disease: A Systematic Review of Outcomes With a Minimum of 5 years Follow-Up

David J Wen  1 , Javad Tavakoli  1 , Joanne L Tipper  1
Affiliations
Review

Lumbar Total Disc Replacements for Degenerative Disc Disease: A Systematic Review of Outcomes With a Minimum of 5 years Follow-Up

David J Wen et al. Global Spine J. 2024 Jul.

Abstract

Study design: Systematic Review.

Objectives: To systematically review the clinical outcomes, re-operation, and complication rates of lumbar TDR devices at mid-to long-term follow-up studies for the treatment of lumbar degenerative disc disease (DDD).

Methods: A systematic search was conducted on PubMed, SCOPUS, and Google Scholar to identify follow-up studies that evaluated clinical outcomes of lumbar TDR in patients with DDD. The included studies met the following criteria: prospective or retrospective studies published from 2012 to 2022; a minimum of 5 years post-operative follow-up; a study sample size >10 patients; patients >18 years of age; containing clinical outcomes with Oswestry Disability Index (ODI), Visual Analog Scale (VAS), complication or reoperation rates.

Results: Twenty-two studies were included with data on 2284 patients. The mean follow-up time was 8.30 years, with a mean follow-up rate of 86.91%. The study population was 54.97% female, with a mean age of 42.34 years. The mean VAS and ODI pain score improvements were 50.71 ± 6.91 and 30.39 ± 5.32 respectively. The mean clinical success and patient satisfaction rates were 74.79% ± 7.55% and 86.34% ± 5.64%, respectively. The mean complication and reoperation rates were 18.53% ± 6.33% and 13.6% ± 3.83%, respectively. There was no significant difference when comparing mid-term and long-term follow-up studies for all clinical outcomes.

Conclusions: There were significant improvements in pain reduction at last follow-up in patients with TDRs. Mid-term follow-up data on clinical outcomes, complication and reoperation rates of lumbar TDRs were maintained longer term.

Keywords: clinical; complications; degenerative disc disease; lumbar disc replacement; lumbar spine; outcomes; total disc replacement.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow diagram of study selection.
Figure 2.
Figure 2.
Pre-operative and post-operative VAS scores of patients with lumbar TDR. Errors bars were presented using CI of scores within each implant group. The student’s t-test (P < .05) showed statistical significance between preoperative and post-operative scores.
Figure 3.
Figure 3.
Pre-operative and post-operative ODI scores of patients with lumbar TDR. Errors bars were presented using CI of scores within each implant group. The student’s t-test (P < .05) showed statistical significance between preoperative and post-operative scores.
Figure 4.
Figure 4.
Comparison between Charité and ProDisc-L for clinical success and patient satisfaction. Errors bars were presented using CI within each implant group.
Figure 5.
Figure 5.
Comparison between Charité and ProDisc-L for complication and reoperation rates. Errors bars were presented using CI within each implant group.
See this image and copyright information in PMC

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