A 5-year Follow-up of a Controlled Mobile Core Lumbar Disc Prosthesis: Clinical Results

Abstract Background Finite element analyses and biomechanical tests have shown that PEEK rods promote fusion and prevent adjacent segment degeneration. The purpose of this study was to evaluate the effects and complications of hybrid surgery with PEEK rods in lumbar degenerative diseases. Methods From January 2015-December 2017, 28 patients who underwent lumbar posterior hybrid surgery with PEEK rods were included in the study. The patients were diagnosed with lumbar disc herniation, lumbar spinal stenosis, or degenerative grade I spondylolisthesis. Before the operation and at the last follow-up, the patients completed lumbar anteroposterior and lateral X-ray, dynamic X-ray, MRI examinations. In addition, at the last follow-up the patients also completed lumbar CT examinations. The radiographic parameters, clinical visual analog scale (VAS) score and Oswestry disability index (ODI) score were compared. Results The average age of the patients was 44.8 ± 12.6 years, and the average follow-up duration was 26.4 ± 3.6 months. The VAS score improved from 6.3 ± 1.6 to 1.0 ± 0.9, and the ODI score decreased from 38.4 ± 10.8 to 6.8 ± 4.6. The fusion rate of the fused segment was 100%. There were no significant changes in the modified Pfirrmann classifications or disc height index for the nonfused segments and the upper adjacent segments from pre- to postoperatively. No cases of screw loosening, broken screws, broken rods or other mechanical complications were found. Conclusion Hybrid surgery with PEEK rods for lumbar degenerative diseases can yield good clinical results and effectively reduce the incidence of complications such as adjacent segment diseases.

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Postchemonucleolysis discectomy versus repeat discectomy: a prospective 1- to 13-year comparison

Journal of Neurosurgery ◽

10.3171/jns.1996.85.2.0231 ◽

1996 ◽

Vol 85 (2) ◽

pp. 231-238 ◽

Cited By ~ 7

Author(s):

Manucher J. Javid

Keyword(s):

Success Rate ◽

Lumbar Disc ◽

Clinical Results ◽

Long Term Results ◽

Content Type ◽

Employment Rates ◽

Second Procedure ◽

Fine Print

✓ This long-term prospective study evaluates the clinical results of subsequent laminectomy in 103 consecutive patients who initially underwent chemonucleolysis (CNL) or laminectomy for lumbar disc herniation. Between 1981 and 1994, 53 patients who had received CNL initially and then underwent laminectomy and 50 patients treated initially with laminectomy underwent a repeat laminectomy. Clinical assessment at 6 weeks showed a success rate of 80.8% for post-CNL laminectomy and 78% for repeat laminectomy. At 6 months, the success rate for patients treated with CNL was 86% versus 78.7% for laminectomy. At 12 months, the overall success rate for the CNL group was 80.4% versus 83.3% for the laminectomy group, but in patients who had not obtained relief from the first procedure the success rate for the second procedure was higher for the post-CNL patients. A questionnaire was sent to all patients for 1- to 13-year follow-up review. The average follow-up period was 6.6 years for post-CNL laminectomy and 5.2 years for repeat laminectomy. The long-term success rate (81.8%) was higher in the post-CNL group compared to 64.4% in the repeat laminectomy group. Seven patients in the post-CNL group and nine in the repeat laminectomy group had undergone a third operation. When these originally successfully treated patients were reassigned after unsuccessful outcomes, the success rate for the CNL groups was 72.7%, versus 51.1% in the laminectomy group (p = 0.049). Employment rates were 80% for patients with CNL (21.8% changed jobs) and 76.3% for patients undergoing laminectomy (48.3% changed jobs) (p = 0.036). In conclusion, patients who underwent laminectomies after receiving CNL had significantly better long-term results than those who had repeat laminectomies.

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Revision after failed discectomy

European Spine Journal ◽

10.1007/s00586-019-06194-9 ◽

2019 ◽

Vol 29 (S1) ◽

pp. 14-21

Author(s):

Christoph Mehren ◽

Lorenz Wanke-Jellinek ◽

Andreas Korge

Keyword(s):

Lumbar Disc ◽

Clinical Results ◽

Scar Tissue ◽

Common Complication ◽

Disc Herniations ◽

Clear Guideline ◽

Supplementary Material ◽

Clinical Register ◽

Recurrent Lumbar Disc Herniation

Abstract Purpose Recurrent lumbar disc herniation is the most common complication after discectomy. Due to the altered anatomy with the presence of scar tissue, the surgical revision of already operated patients could be a surgical challenge. Methods We describe the microsurgical revision technique step by step with the evaluation of our own clinical results in comparison with primary lumbar disc surgeries. The clinical data are based on a clinical register with 2576 recorded primary surgeries (PD) and 592 cases of revisions (RD) with 12- and 24-month follow-up (FU). The intraoperative dura lesion rates of the surgeries between 2016 and 2018 were recorded retrospectively. Data from 894 primary disc surgeries and 117 revisions were evaluated. Results The ODI and the VAS for leg and back pain improved in both groups significantly with slightly inferior outcome of the revision group. The ODI improved from 46.3 (PD) and 45.9 (RD), respectively, to 12.6 (PD) and 22.9 (RD) at the 24-month FU. The VAS dropped down as well in both group [VAS back: 47.8 (PD) and 43.9 (RD) to 19.9 and 32.2 at the 24-month FU; VAS leg: 62.9 (PD) and 65.5 (RD) to 15.6 and 26.8 at the 24-month FU]. During the primary interventions, we observed 1.5% (11/894) and during revisions 7.7% (9/117) of dura lesions. Conclusions There is no clear guideline for the surgical treatment of recurrent disc herniations. In most cases, a pure re-discectomy is sufficient and can be performed safely and effectively with the help of a microscope. Graphic abstract These slides can be retrieved under Electronic Supplementary Material.

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Clinical Results, Range of Motion and Centers of Rotation with the Six Degrees of Freedom Viscoelastic LPESP Lumbar Disc Prosthesis: a 5-Year Prospective Study in 76 Patients

The Spine Journal ◽

10.1016/j.spinee.2017.08.082 ◽

2017 ◽

Vol 17 (10) ◽

pp. S212

Author(s):

Jean-Yves Lazennec ◽

Olivier Ricart ◽

Stephane Ramare

Keyword(s):

Prospective Study ◽

Range Of Motion ◽

Degrees Of Freedom ◽

Lumbar Disc ◽

Clinical Results ◽

Disc Prosthesis ◽

Six Degrees Of Freedom

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Kineflex (Centurion) Lumbar Disc Prosthesis: Insertion Technique and 2-Year Clinical Results in 100 Patients

SAS Journal ◽

10.1016/s1935-9810(07)70044-0 ◽

2007 ◽

Vol 1 (1) ◽

pp. 28-35 ◽

Cited By ~ 5

Author(s):

Ulrich R. Hähnle ◽

Ian R. Weinberg ◽

Karen Sliwa ◽

Barry MBE Sweet ◽

Malan de Villiers

Keyword(s):

Lumbar Disc ◽

Clinical Results ◽

Disc Prosthesis ◽

Insertion Technique

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Kineflex (Centurion) Lumbar Disc Prosthesis: Insertion Technique and 2-Year Clinical Results in 100 Patients

The International Journal of Spine Surgery ◽

10.1016/sasj-2006-0005-rr ◽

2007 ◽

Vol 1 (1) ◽

pp. 28-35 ◽

Cited By ~ 1

Author(s):

Ulrich R. Hähnle ◽

Ian R. Weinberg ◽

Karen Sliwa ◽

Barry MBE Sweet ◽

Malan de Villiers

Keyword(s):

Lumbar Disc ◽

Clinical Results ◽

Disc Prosthesis ◽

Insertion Technique

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Clinical and Radiological Assessment of Lumbar Disc Prosthesis with Controlled Mobility with Five-Year Follow-Up: A Prospective Study on 411 Patients

The Spine Journal ◽

10.1016/j.spinee.2015.07.117 ◽

2015 ◽

Vol 15 (10) ◽

pp. S128

Author(s):

Jacques Beaurain ◽

Jerome Allain ◽

Joel Delecrin ◽

Herve L. Chataigner ◽

Thierry Dufour ◽

...

Keyword(s):

Prospective Study ◽

Lumbar Disc ◽

Radiological Assessment ◽

Disc Prosthesis ◽

Controlled Mobility ◽

A Prospective Study

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Suprapedicular Circumferential Opening Technique of Percutaneous Endoscopic Transforaminal Lumbar Discectomy for High Grade Inferiorly Migrated Lumbar Disc Herniation

BioMed Research International ◽

10.1155/2018/5349680 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Hyeun Sung Kim ◽

Farid Yudoyono ◽

Byapak Paudel ◽

Ki Joon Kim ◽

Jee-Soo Jang ◽

...

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Clinical Results ◽

Outcome Evaluation ◽

Lumbar Discectomy ◽

Leg Pain ◽

High Grade ◽

The Mean

Purpose. To evaluate the efficacy of suprapedicular circumferential opening technique (SCOT) of percutaneous endoscopic transforaminal lumbar discectomy (PETLD) for high grade inferiorly migrated lumbar disc herniation. Material and Methods. Eighteen consecutive patients who presented with back and leg pain with a single-level high grade inferiorly migrated lumbar disc herniation were included. High grade inferiorly migrated disc was removed by the SCOT through PETLD approach. Outcome evaluation was done with visual analog scale (VAS) and Mac Nab’s criteria. Result. There were 14 males and 4 females. The mean age of patients was 53.3±14.12 years. One, 4, and 13 patients had disc herniation at L1-2, L3-4, and L4-5 levels, respectively, on MRI, which correlated with clinical findings. The mean follow-up duration was 8.4±4.31 months. According to Mac Nab’s criteria, 9 patients (50%) reported excellent and the remaining 9 patients (50%) reported good outcomes. The mean preoperative and postoperative VAS for leg pain were 7.36±0.73 and 1.45±0.60, respectively (p<0.001). Improvement in outcomes was maintained even at final follow-up. There was no complication. Conclusion. In this preliminary study we achieved good to excellent clinical results using the SCOT of PETLD for high grade inferiorly migrated lumbar disc herniation.

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