Abstract
A subgroup of nine patients, five women and four men, who received lumbar disc prostheses in a segment adjacent to previous posterolateral instrumented fusions (one or two levels) is reviewed. Two patients underwent double-level disc replacement. The mean age was 46.1 years (33 to 62). All patients had marked flattening of the lumbar spine before the operation. One patient developed subsidence within two weeks of the procedure but went on to a satisfactory result. One patient with a double-level disc replacement needed another operation because of a missed far out lateral disc. On day five after the procedure, the top-level disc was removed, the level properly decompressed and the disc reinserted, with good results.
The mean postoperative hospital stay was 3.9 days (3 to 8). Within a mean time of 32 days (21 to 42), all patients returned to their previous occupations. Follow-up ranged from 3 to 19 months. At the latest follow-up, four of the patients were satisfied and five were very satisfied.
Disc replacement seems an ideal salvage procedure for junctional failure after previous fusions. The short-term clinical results are good.
The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at PO Box 47363, Parklands, Johannesburg 2121, South Africa.
