Long-term clinical and radiological outcomes after total lumbar disc replacement at the lumbosacral junction
The study objective is to analyze long-term clinical and radiological outcomes in patients after performing total lumbar disc replacement at the level of the lumbosacral junction.Materials and methods. A multicenter retrospective observational cohort study was performed. The study included medical records of patients who underwent total lumbar disc replacement at the level of the lumbosacral junction. Both clinical and instrumental parameters were assessed. According to the eligibility criteria, 93 patients were included in the study (38 men, 55 women, mean age 39.9 ± 7.5 years). The average postoperative observation period for the respondents was 33.4 ± 9.5 months.Results. The severity of pain in the lumbar spine on a visual analogue scale significantly decreased (from 7.3 ± 2.5 to 1.9 ± 2.2 cm, p 0.05) was verified. The value of global lumbar lordosis after the installation of a lumbar intervertebral disc prosthesis at the level of the lumbosacral junction significantly increased from 49.1 ± 4.8° to 55.6 ± 5.5° (p <0.001). Intervertebral disc prostheses with a lordotic angle of 10° reliably positively correlate with an increase in the values of segmental lordosis, in contrast to implants with an angle of 6° (rS = 0.86, p = 0.04). The severity of pain in the lumbar spine according to visual analogue scale and the range of motion of the operated segment has a significant negative correlation in the late periods of postoperative follow-up (24 and 36 months, rS = -0.74, p = 0.015).Conclusion. The total lumbar disc replacement technique is an effective method of surgical treatment of patients with degenerative diseases of the intervertebral discs of the lumbosacral spine, including at the level of the lumbosacral junction.