Patient Reported outcome Measures following Multi-Level Lumbar Total Disc Arthroplasty for the Treatment of Multi-Level Degenerative Disc Disease

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

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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 languageEnglish
JournalSpine
DOIs
Publication statusE-pub ahead of print - 16 Aug 2019

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Total Disc Replacement
Patient Satisfaction
Therapeutics
Spine
Patient Reported Outcome Measures
Leg
Pain

Cite this

@article{3c8f11f16f79490088ef2499e451acda,
title = "Patient Reported outcome Measures following Multi-Level Lumbar Total Disc Arthroplasty for the Treatment of Multi-Level 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 = "2019",
month = "8",
day = "16",
doi = "10.1097/BRS.0000000000003201",
language = "English",
journal = "Spine",
issn = "0362-2436",
publisher = "Lippincott Williams & Wilkins",

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TY - JOUR

T1 - Patient Reported outcome Measures following Multi-Level Lumbar Total Disc Arthroplasty for the Treatment of Multi-Level 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 - 2019/8/16

Y1 - 2019/8/16

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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U2 - 10.1097/BRS.0000000000003201

DO - 10.1097/BRS.0000000000003201

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JO - Spine

JF - Spine

SN - 0362-2436

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