TWO-YEAR FOLLOW-UP RESULTS OF LUMBAR DISC NUCLEUS PROSTHESIVERSUS INTERBODY FUSION CAGES IN THE TREATMENT OF SYMPTOMATIC DEGENERATIVE DISC DISEASE

Abstract

Traditionally, spinal fusion has been the treatment of choice for individuals who have not found pain relief for chronic back pain through conservative treatment. Premature degeneration at adjacent levels of the spine remains one of the more vexing problems facing spinal surgeons when advising relatively young people to consider lumbar fusion surgery. The use of an artificial disc to replace a damaged intervertebral disc that is generating chronic back pain is currently in various phases of development.

Patients with a primary diagnosis of degenerative lumbar disc disease accompained by low back pain and unilateral leg pain, having failed conservative treatment, were considered for the surgical procedure. Twenty-eight patients were randomized into two groups of 15 and 13, respectively, using a random numbar table. Group 1 had two threaded titanium expanding fusion cages inserted posterior with bilateral medial facetectomy. Group 2 had a disc nucleus replacement device inserted posterior with unilateral medial facetectomy and hemilaminectomy

The artificial disc offers several theoretical benefits over the spinal fusion for chronic back pain including potentially enhanced clinical success rates as pain reduction and potential to avoid premature degeneration at adjacent levels of the spine by maintaining normal spinal motion.