CLINICAL RESULTS OF LUMBAR TOTAL DISC ARTHROPLASTY IN ACCORDANCE WITH MODIC SIGNS, WITH A 2 YEAR MINIMAL FOLLOW-UP

Abstract

Study Design and Objectives: The aim of this prospective study is to analyze clinical results of lumbar total disc arthroplasty according to the MRI evaluation of the disc degeneration.

Summary of Background Data: Disc degeneration of the lumbar spine is associated with different signs on MRI study. Such lesions can be treated by spinal fusion or disc arthroplasty, and no strong therapeutic consensus is available at the moment. Non-fusion techniques have been developed for the treatment of disc degeneration disease and are able to preserve intervertebral mobility with good clinical results.

Materials and Methods: 221 patients with a mean age of 42 years have been included in this study. 107 patients were classified Modic 0, 65 Modic 1 and 49 Modic 2. Clinical evaluation (Oswestry Disability Index, Lumbar and Radicular visual analogic score) was performed preoperatively and at 3, 6, 12 and 24 months postoperatively.

Results: Mean follow-up of the series was 30 months [24–72 months]. A significant clinical improvement (p< 0, 05) was observed on each criteria between the preoperative evaluation and last follow-up. On the multivariate analysis between the three groups, a significant difference was observed, with better clinical results in the group classified Modic 1.

Conclusion: Total lumbar disc arthroplasty provide a significant clinical improvement in patients with disc degenerative disease with a minimum follow-up of two years. Best results were achieved in the group of patients classified as Modic 1 on the MRI evaluation. These results are applicable for the selection of indications of total disc arthroplasty and also for the patient information preoperatively.