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JOURNAL OF NEUROSURGICAL SCIENCES
Rivista di Neurochirurgia
Indexed/Abstracted in: e-psyche, EMBASE, PubMed/MEDLINE, Neuroscience Citation Index, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,651
Journal of Neurosurgical Sciences 2017 February;61(1):14-21
Copyright © 2015 EDIZIONI MINERVA MEDICA
Segmental translation after lumbar total disc replacement using Prodisc-L®: associated factors and relation to facet arthrosis
Myung H. SHIN 1, Kyeong S. RYU 2 ✉, Nitesh K. RATHI 3, Chun K. PARK 2
1 Department of Neurosurgery, Incheon St Mary’s Hospital, The Catholic University, Incheon, South Korea; 2 Department of Neurosurgery, Seoul St Mary’s Hospital, The Catholic University, Seoul, South Korea; 3 Department of Orthopedics, Sri Ramachandra Medical Centre, Sri Ramachandra University, Chennai, India
BACKGROUND: Segmental translation after lumbar total disc replacement (TDR) with ProDisc-L® prosthesis frequently observed radiographic findings during follow-up period. However its precise pathomechanism and relation with facet arthrosis have not been investigated yet. This study was performed to evaluate possible factors that affect postoperative segmental translation and to identify its relation with facet joint degeneration after lumbar TDR using ProDisc-L® prosthesis.
METHODS: Thirty-five consecutive patients, who underwent lumbar TDR using ProDisc-L®, completed minimum 24 months follow-up. Segmental translation was assessed postoperatively at 1 month and at least at 24 months by using dynamic plain radiograph. Segmental translation was assessed in relation to patient age, sex, change of functional spinal unit (FSU) height, segmental range of motion (ROM), global lumbar ROM, implanted level, relative prosthesis size and prosthesis position. The comparison of segmental translation between progressive facet arthrosis (PFA) group and non-PFA group was also made.
RESULTS: The mean segmental translation was 0.49±0.49 mm at 1 month after surgery and showed significant increase to 0.83±0.78 mm at last follow-up (P=0.014). Change of FSU height, segmental ROM, global lumbar ROM, implanted level and relative size of prosthesis were the significant factors among the variables related to segmental translation that authors assessed (P=0.032, P=0.000, P=0.001, P=0.046 and P=0.042, respectively). There was no significant intergroup difference of mean segmental translation between PFA group and non-PFA group (P=0.586).
CONCLUSIONS: This study demonstrates that segmental translation after TDR using ProDisc-L® has significant relations with change of FSU height, segmental ROM, global lumbar ROM, implanted level and relative size of prosthesis. With the intergroup comparison, PFA group did not show significant higher segmental translation than non-PFA group.
KEY WORDS: Total disc replacement - Prostheses and implants - Joint diseases