Results of Total Lumbar Intervertebral Disk Replacement With M6-L: A Multicenter Study

Abstract

Objective: In this paper we report the clinical and radiological results of lumbar intervertebral disk (IVD) replacement with M6-L for the treatment of patients with IVD degeneration. Methods: One hundred and fifty-six patients with IVD degeneration were operated with the one level implantation of an M6-L prosthesis at three neurosurgical departments, in Irkutsk, Krasnoyarsk and Vladivostok. We assessed pain intensity (VAS), the Oswestry disability index (ODI) and outcomes by the Macnab scale up to 36 months after surgery. Instrumental data were used to assess range of motion in the operated segment and heterotopic ossification by the McAfee-Suchomel classification. Results: The average VAS before surgery was 6.9 ± 1.6 cm. After surgery, this value reduced significantly, to an average of 1.3 ± 1.2 cm (p<0.001). The average ODI before surgery was 40.2 ± 6.9%, and after IVD arthroplasty, this indictor improved to 12.3 ± 6.1% (p <0.001). Range of motion in the operated segment at baseline averaged 36.8 ± 2.6 o , and within 36 months after the operation, this had increased to 41.2 ± 2. McAfee-Suchomel. Resultados: El valor promedio de la EVA para el dolor antes de la cirugía fue de 6,9 ± 1,6 cm. Después de la cirugía, ese valor tuvo una reducción significativa, en promedio de 1,3 ± 1,2 cm (p < 0,001). El ODI promedio antes de la cirugía fue de 40,2 ± 6,9% y después de la artroplastia del IVD ese índice mejoró para 12,3 ± 6,1% (p < 0,001). El rango de movimiento del segmento operado al inicio del estudio fue en promedio 36,8 ± 2,6 o y 36 meses después de la cirugía, aumentó a 41,2 ± 2,9 o . Durante toda el seguimiento se observaron signos de osificación heterotópica grave (13,4%, n = 21) o moderada (10,2%, n = 16 RESUMEN Objetivo: En este trabajo, relatamos los resultados clínicos y radiológicos de la sustitución de disco intervertebral lumbar (IVD) con M6-L para tratamiento de pacientes con degeneración de IVD. Métodos: Ciento cincuenta y seis pacientes con degeneración de IVD fueron operados con la implantación de prótesis M6-L en un nivel, en tres departamentos de neurocirugía de Irkutsk, Krasnoyarsk y Vladivostok. Se evaluó la intensidad del dolor (EVA), el Índice de Discapacidad de Oswestry (ODI) y los resultados por escala de Macnab hasta 36 meses después de la cirugía. Los datos de instrumentación se utilizaron para evaluar el rango de movimiento en el segmento operado y la osificación heterotópica mediante la clasificación de

Impact of heterotopic ossification following lumbar total disk replacement: a systematic review

“…Five studies reported on ROM at the index level before and after lumbar TDR surgery and therefore a regression was not performed due to too few publications reporting ROM [ 47 , 48 , 53 , 55 , 56 ]. The mean percentage change in ROM before and after lumbar TDR ranged from -37% to 28% and the mean across the studies was 8.15% improvement.…”

“…All studies apart from two reported the mean age of the participants [ 53 , 69 ]. The mean age ranged from 36 to 59.4 years and the mean across all the studies was 41.7 years.…”

“…All studies except three reported the surgical approach during the implantation of the artificial disc [ 53 , 57 , 67 ]. Lateral retroperitoneal approach was conducted in three studies [ 52 , 54 , 59 ].…”

“…There was no statistically significant correlation between the regression of the percentage of prosthesis implanted at each level in each study and the proportion of participants with HO ( p > 0.01). 11 studies reported the mean surgical time during the implant surgery[ 47 – 49 , 52 , 53 , 55 , 58 – 60 , 65 , 72 ]. The mean surgical time across all the studies was 116 min and ranged from 90 to 168 min.…”

“…The mean surgical time across all the studies was 116 min and ranged from 90 to 168 min. Blood loss during the implant surgery was reported by 10 studies [ 47 – 50 , 52 , 53 , 55 , 58 , 59 , 65 ]. The mean blood loss across all the studies was 169 ml and ranged from 58 to 472 ml.…”