Document Detail

Index level mobility after total lumbar disc replacement: is it beneficial or detrimental?
MedLine Citation:
PMID:  19532000     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: Analysis of segmental and total lumbar range of motion (ROM) before and after total lumbar disc replacement. OBJECTIVE: To examine the relationship between absolute segmental and total lumbar ROM and evolution of ROM on clinical outcome. SUMMARY OF BACKGROUND DATA: At the moment, data are scarce with regard to the evolution of total lumbar ROM (t-ROM) and segmental ROM (s-ROM) after total lumbar disc replacement. Moreover, the influence of ROM on clinical outcome still is unclear and remains a matter of controversial debate. METHODS.: Forty patients operated on for mono- or bisegmental symptomatic degenerative disc disease with a total of 45 artificial discs (ProDisc-L, Synthes) were analyzed. Pre- and postoperative s-ROM and t-ROM were measured on flexion/extension radiographs. The Oswestry Low Back Pain Disability Questionnaire and the Short Form 36 Health Survey were obtained pre- and postoperatively with a minimum follow-up of 3 years (37-64 months). RESULTS: Neither the s-ROM (pre-/postoperatively: 6.9 degrees/7.3 degrees) nor the t-ROM (pre-/postoperatively: 34.9 degrees/35.8 degrees) did change significantly after implantation of an artificial disc. Postoperatively, there was an increase of s-ROM (t-ROM) in 40% (40%), a decrease in 35% (30%), and no change in 25% (30%) of the patients. A significant inferior clinical outcome only was observed in patients with decreased t-ROM. The resulting postoperatively s-ROM had no significant impact on outcome. CONCLUSION: Neither the absolute s-ROM nor the evolution of s-ROM (increase, decrease, unchanged) was positively correlated with better clinical outcome. Although a positive correlation was observed with regard to t-ROM.
Balkan Cakir; René Schmidt; Thomas Mattes; Christian R Fraitzl; Heiko Reichel; Wolfram Käfer
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Spine     Volume:  34     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-06-17     Completed Date:  2009-09-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  917-23     Citation Subset:  IM    
Department of Orthopaedic Surgery, University of Ulm, Ulm, Germany.
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MeSH Terms
Disability Evaluation
Diskectomy / methods*
Follow-Up Studies
Intervertebral Disk / pathology,  physiopathology,  surgery*
Intervertebral Disk Displacement / surgery*
Lumbar Vertebrae / pathology,  physiopathology,  surgery*
Prostheses and Implants
Range of Motion, Articular
Treatment Outcome

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