Abstract
Aim
To evaluate the level of health resource utilisation by patients after lumbar total disc replacement (TDR) for mechanical low back pain.
Method
At our centre, 35 patients underwent TDR and were followed prospectively from surgery. All surgery was performed by the senior author. Patients were followed routinely in clinic at yearly intervals. In addition, the patients and their GPs were contacted via telephone. Information gathered included ODI and VAS, satisfaction with surgery and return to work. We specifically established whether the patients continued to seek healthcare, for persistent back symptoms, from professionals (both NHS and private) including their GP, pain clinic, physiotherapist, acupuncturist, chiropractor or another spinal surgeon, and had any further interventions.
Results
We have complete dataset on 30 out of 35 patients and are the subject of this study. There were 13 men, with a mean age of 37.7 years (range 28-45 years), and 17 women with a mean age of 49.8 years (range 27-62 years). Surgery was single level in 26 and two levels in 6 cases. Patients were satisfied with the outcome of surgery in 21 cases (70%), not satisfied in 7. Two cases had implant failures. 25 patients were working pre-operatively and 26 were working postoperatively. Eighteen patients required no further healthcare input. Five had had pain clinic reviews, six had seen their GPs (1-6 visits) and one another spinal surgeon (after late liner extrusion). Seven had facet injections and two had epidurals. One patient underwent posterior fusion for implant migration.
Conclusion
In our series TDR is successful in 70% and 60% of the entire cohort needed no further healthcare input. After successful TDR there is almost no ongoing use of health resources.
