Patient-Reported Outcome Measures after Multilevel Lumbar Total Disc Arthroplasty for the Treatment of Multilevel Degenerative Disc Disease

Matthew Scott-Young; Laurence McEntee; Mario Zotti; Ben Schram; James Furness; Evelyne Rathbone; Wayne Hing

doi:10.1097/BRS.0000000000003201

Patient-Reported Outcome Measures after Multilevel Lumbar Total Disc Arthroplasty for the Treatment of Multilevel Degenerative Disc Disease

Matthew Scott-Young, Laurence McEntee, Mario Zotti, Ben Schram, James Furness, Evelyne Rathbone, Wayne Hing

Faculty of Health Sciences & Medicine

Research output: Contribution to journal › Article › Research › peer-review

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Abstract

STUDY DESIGN: Case series OBJECTIVE.: The aim of this study was to assess the patient reported outcome measures (PROMs) and patient satisfaction of multi-level lumbar total disc arthroplasty (TDA) for symptomatic multilevel degenerative disc disease (MLDDD).

SUMMARY OF BACKGROUND DATA: TDA has been shown to be safe and effective for the treatment of symptomatic single level degenerative disc disease (DDD). There is minimal PROMs data on the mid- to long-term outcomes of multi-level TDA constructs.

METHODS: Prospectively collected PROMs were analysed from patients receiving multi-level TDA for symptomatic MLDDD. Data was collected pre-operatively and post-operatively at 3, 6 and 12 months, then yearly. PROMs included patient satisfaction, Visual Analogue Score back and leg, Oswestry Disability Index and Roland Morris Disability Questionnaire.

RESULTS: 122 patients (77 males, 45 females) who had pre-operative and at least 24-month follow-up data were included. The average age was 42 ± 8.2 years (range 21-61) and mean follow-up 7.8 years (range 2-10). The majority received two level TDA, except two patients (1.6%) who received three level TDA. The two three-level TDA's were at the levels L3-4, L4-5 and L5-S1, while most two levels (n = 110, 90.2%) were at L4-5 and L5-S1; the remainder (n = 10, 8.2%) being at L3-4 and L4-5. Implants used were Charité (DePuy Spine, Raynham, MA, USA) in 119 patients (240 levels) and InMotion (DePuy Spine, Raynham, MA, USA) in 3 patients (6 levels). Improvement in pain and disability scores were both clinically and statistically significant (p < 0.001) and this improvement was sustained in those patients over the course of their follow-up. 92% of patients reported good or excellent satisfaction with treatment at final review.

CONCLUSIONS: Multi-level TDA constructs for MLDDD demonstrate favourable and sustained clinical outcomes at mid- to long-term follow-up.

LEVEL OF EVIDENCE: 4.

Original language	English
Pages (from-to)	18-25
Number of pages	8
Journal	Spine
Volume	45
Issue number	1
Early online date	16 Aug 2019
DOIs	https://doi.org/10.1097/BRS.0000000000003201
Publication status	Published - 1 Jan 2020

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10.1097/BRS.0000000000003201Licence: CC BY-NC-ND

Patient Reported outcome Measures following Multi-Level LumbarAccepted author manuscript, 450 KBLicence: CC BY-NC-ND

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@article{3c8f11f16f79490088ef2499e451acda,

title = "Patient-Reported Outcome Measures after Multilevel Lumbar Total Disc Arthroplasty for the Treatment of Multilevel Degenerative Disc Disease",

abstract = "STUDY DESIGN: Case series OBJECTIVE.: The aim of this study was to assess the patient reported outcome measures (PROMs) and patient satisfaction of multi-level lumbar total disc arthroplasty (TDA) for symptomatic multilevel degenerative disc disease (MLDDD).SUMMARY OF BACKGROUND DATA: TDA has been shown to be safe and effective for the treatment of symptomatic single level degenerative disc disease (DDD). There is minimal PROMs data on the mid- to long-term outcomes of multi-level TDA constructs.METHODS: Prospectively collected PROMs were analysed from patients receiving multi-level TDA for symptomatic MLDDD. Data was collected pre-operatively and post-operatively at 3, 6 and 12 months, then yearly. PROMs included patient satisfaction, Visual Analogue Score back and leg, Oswestry Disability Index and Roland Morris Disability Questionnaire.RESULTS: 122 patients (77 males, 45 females) who had pre-operative and at least 24-month follow-up data were included. The average age was 42 ± 8.2 years (range 21-61) and mean follow-up 7.8 years (range 2-10). The majority received two level TDA, except two patients (1.6%) who received three level TDA. The two three-level TDA's were at the levels L3-4, L4-5 and L5-S1, while most two levels (n = 110, 90.2%) were at L4-5 and L5-S1; the remainder (n = 10, 8.2%) being at L3-4 and L4-5. Implants used were Charit{\'e} (DePuy Spine, Raynham, MA, USA) in 119 patients (240 levels) and InMotion (DePuy Spine, Raynham, MA, USA) in 3 patients (6 levels). Improvement in pain and disability scores were both clinically and statistically significant (p < 0.001) and this improvement was sustained in those patients over the course of their follow-up. 92% of patients reported good or excellent satisfaction with treatment at final review.CONCLUSIONS: Multi-level TDA constructs for MLDDD demonstrate favourable and sustained clinical outcomes at mid- to long-term follow-up.LEVEL OF EVIDENCE: 4.",

author = "Matthew Scott-Young and Laurence McEntee and Mario Zotti and Ben Schram and James Furness and Evelyne Rathbone and Wayne Hing",

year = "2020",

month = jan,

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doi = "10.1097/BRS.0000000000003201",

language = "English",

volume = "45",

pages = "18--25",

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T1 - Patient-Reported Outcome Measures after Multilevel Lumbar Total Disc Arthroplasty for the Treatment of Multilevel Degenerative Disc Disease

AU - Scott-Young, Matthew

AU - McEntee, Laurence

AU - Zotti, Mario

AU - Schram, Ben

AU - Furness, James

AU - Rathbone, Evelyne

AU - Hing, Wayne

PY - 2020/1/1

Y1 - 2020/1/1

N2 - STUDY DESIGN: Case series OBJECTIVE.: The aim of this study was to assess the patient reported outcome measures (PROMs) and patient satisfaction of multi-level lumbar total disc arthroplasty (TDA) for symptomatic multilevel degenerative disc disease (MLDDD).SUMMARY OF BACKGROUND DATA: TDA has been shown to be safe and effective for the treatment of symptomatic single level degenerative disc disease (DDD). There is minimal PROMs data on the mid- to long-term outcomes of multi-level TDA constructs.METHODS: Prospectively collected PROMs were analysed from patients receiving multi-level TDA for symptomatic MLDDD. Data was collected pre-operatively and post-operatively at 3, 6 and 12 months, then yearly. PROMs included patient satisfaction, Visual Analogue Score back and leg, Oswestry Disability Index and Roland Morris Disability Questionnaire.RESULTS: 122 patients (77 males, 45 females) who had pre-operative and at least 24-month follow-up data were included. The average age was 42 ± 8.2 years (range 21-61) and mean follow-up 7.8 years (range 2-10). The majority received two level TDA, except two patients (1.6%) who received three level TDA. The two three-level TDA's were at the levels L3-4, L4-5 and L5-S1, while most two levels (n = 110, 90.2%) were at L4-5 and L5-S1; the remainder (n = 10, 8.2%) being at L3-4 and L4-5. Implants used were Charité (DePuy Spine, Raynham, MA, USA) in 119 patients (240 levels) and InMotion (DePuy Spine, Raynham, MA, USA) in 3 patients (6 levels). Improvement in pain and disability scores were both clinically and statistically significant (p < 0.001) and this improvement was sustained in those patients over the course of their follow-up. 92% of patients reported good or excellent satisfaction with treatment at final review.CONCLUSIONS: Multi-level TDA constructs for MLDDD demonstrate favourable and sustained clinical outcomes at mid- to long-term follow-up.LEVEL OF EVIDENCE: 4.

AB - STUDY DESIGN: Case series OBJECTIVE.: The aim of this study was to assess the patient reported outcome measures (PROMs) and patient satisfaction of multi-level lumbar total disc arthroplasty (TDA) for symptomatic multilevel degenerative disc disease (MLDDD).SUMMARY OF BACKGROUND DATA: TDA has been shown to be safe and effective for the treatment of symptomatic single level degenerative disc disease (DDD). There is minimal PROMs data on the mid- to long-term outcomes of multi-level TDA constructs.METHODS: Prospectively collected PROMs were analysed from patients receiving multi-level TDA for symptomatic MLDDD. Data was collected pre-operatively and post-operatively at 3, 6 and 12 months, then yearly. PROMs included patient satisfaction, Visual Analogue Score back and leg, Oswestry Disability Index and Roland Morris Disability Questionnaire.RESULTS: 122 patients (77 males, 45 females) who had pre-operative and at least 24-month follow-up data were included. The average age was 42 ± 8.2 years (range 21-61) and mean follow-up 7.8 years (range 2-10). The majority received two level TDA, except two patients (1.6%) who received three level TDA. The two three-level TDA's were at the levels L3-4, L4-5 and L5-S1, while most two levels (n = 110, 90.2%) were at L4-5 and L5-S1; the remainder (n = 10, 8.2%) being at L3-4 and L4-5. Implants used were Charité (DePuy Spine, Raynham, MA, USA) in 119 patients (240 levels) and InMotion (DePuy Spine, Raynham, MA, USA) in 3 patients (6 levels). Improvement in pain and disability scores were both clinically and statistically significant (p < 0.001) and this improvement was sustained in those patients over the course of their follow-up. 92% of patients reported good or excellent satisfaction with treatment at final review.CONCLUSIONS: Multi-level TDA constructs for MLDDD demonstrate favourable and sustained clinical outcomes at mid- to long-term follow-up.LEVEL OF EVIDENCE: 4.

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DO - 10.1097/BRS.0000000000003201

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Patient-Reported Outcome Measures after Multilevel Lumbar Total Disc Arthroplasty for the Treatment of Multilevel Degenerative Disc Disease

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