Abstract
Introduction: Total disc arthroplasty may offer the same clinical benefits as interbody fusion in symptomatic degenerative disc disease, while providing motion that may protect the adjacent level discs from the abnormal and undue stresses associated with fusion.
Objectives: To prospectively review the preliminary results of the Maverick Lumbar Disc Prosthesis (Medtronic, USA) at maximum 2 year follow-up.
Methods: The first 51 patients (26 M, 25F, age 45.5 mean, 53 levels implanted) were prospectively analyzed. Outcome data included the Oswestry Disability Score (ODI), Visual Analog Scale (VAS) for back and leg pain and SF-36 preoperatively and at routine scheduled follow-ups. Radiographic analysis included sagittal balance parameters and range of motion of the implanted level.
Results: Clinical success (ODI change > 15, FDA) was 82% and 86%, at 6 months and 1 year follow-up respectively. VAS (back) improved from 7.9 (±1.4) to 3.8 (±2.9), and VAS (leg) from (4.6 ± 3.2) to 3.1 (±3.2). All improvements were statistically significant. Two approach, 2 technique and 2 general related complications occurred. Implanted level range of motion ranged from 3 to 12 degrees (mean 6 ± 4 degrees). There was no significant change in any of the sagittal balance variables studied, but a local realignment of the L4-5 L5-S1 segments was found.
Conclusion: These results compare favorably with the short-term clinical outcomes associated with ALIF. It appears that the prosthesis has enough freedom of motion to allow the patient to maintain the natural sagittal and spino-pelvic balance, with normal range of motion. These early favorable clinical results or the influence on adjacent motion segments can be assessed only after a long term prospective randomized study comparing the Maverick to fusion procedures.
The abstracts were prepared by Ms Orah Naor. Correspondence should be addressed to Israel Orthopaedic Association at PO Box 7845, Haifa 31074, Israel.
