138. ANALYSIS OF THE CLINICAL RESULTS OF LUMBAR DISC ARTHROPLASTY AS A FUNCTION OF THE TYPE OF DEGENERATIVE DISCOPATHY

Abstract

Purpose of the study: The purpose of this work was to analysis the clinical results of lumbar disc arthroplasty as a function of the type of degenerative discopathy in patients with MODIC 1 anomalies at the MRI.

Material and methods: Sixty-five patients were included in this prospective study over a two-year period. Mean age was 43 years (range 23–59). All patients had a single level lumbar discopathy with MODIC 1 signs on the MRI. The discopathy was classed H0 for isolated degenerative disc disease, H1 for an associated disc overhang, H2 in the event of a recurrent disc hernia, and H3 if there was a post-discectomy syndrome. The clinical analysis was based on the VAS for lumbar and radicular pain and the Oswestry score noted preoperatively then at 3, 6, 12 and 24 months postoperatively.

Results: In the 12 patients classed H0, a significant decrease in the lumbar and radicular VAS was noted at 24 months, similarly for the H1 patients (n=25), the H2 patients (n=12) and the H3 patients (n=16). The Oswestry score also improved significantly in the different groups: 25/50 preoperatively to 5/50 at last follow-up in H0, 25/50 to 7/50 in H1, 27/50 to 11/50 in H2, and 31/50 to 13/50 in H3. There was a statistically significant difference between the results in H0 and H3 and between H1 and H3 (p< 0.05).

Discussion: In patients with degenerative discopathy with MODIC1 signs on the MRI, the results of disc arthroplasty are globally satisfactory with a significant clinical improvement. There are however statistically significant difference as a function of the type of discopathy. These preliminary data provide a base for reflection concerning the expected results and about information to give patients for whom a lumbar disc arthroplasty may be proposed.