Prior surgery did not negatively impact patients undergoing lumbar total disc replacement
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Key takeaways:
- Prior surgery did not negatively impact surgical outcomes for patients undergoing lumbar total disc replacement.
- Prior surgery should not be an “obstacle” to the intervention.
Prior surgery did not negatively impact surgical outcomes for patients undergoing lumbar total disc replacement and should not be an “obstacle” to the intervention, according to presented results.
“It’s generally thought that patients who had had prior spine surgery tend to have less favorable outcomes if they have another subsequent surgery,” Jessica L. Shellock, MD, said during her presentation at the North American Spine Society Annual Meeting. “Yet this has rarely been investigated in studies involving lumbar [total disc replacement].”
Shellock and colleagues retrospectively analyzed data from a consecutive series of approximately 800 patients who did not have surgery prior to undergoing lumbar total disc replacement (TDR) at one, two or three levels and 360 patients who had surgery prior to lumbar TDR. Types of prior surgery included discectomy (73.9%), intradiscal treatment (13.1%), fusion (9.9%) and other (3%).
Outcome measures were collected at 2 years postoperatively and included VAS back and leg pain scores, Oswestry Disability Index (ODI) score and reoperations.
Shellock and colleagues found patients without prior surgery and patients with prior surgery had similar statistically significant improvements in VAS back and leg pain scores as well as ODI scores. They also found no difference in reoperation rates between the groups.
“It’s clearly important to evaluate patients with prior surgery to ensure that they are a good candidate for the disc replacement, particularly paying attention to the posterior elements and stability,” Shellock said.
“However, if patients are a good candidate for a TDR, prior surgery in and of itself should not be an obstacle to achieving a good clinical outcome,” she concluded.
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Shellock JL, et al. Paper 168. Presented at: North American Spine Society Annual Meeting; Oct. 18-21, 2023; Los Angeles.
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