[Sagittal alignment and segmental range of motion after total disc replacement of the lumbar spine].
OBJECTIVE
To evaluate changes in static and dynamic values, X-rays of patients who underwent total disc replacement for degenerative disc disease were analyzed.


METHODS
An analysis of pre- and postoperative lateral X-rays in 22 patients with 24 total disc replacements (Prodics, Spine Solutions) was performed. The total lumbar lordosis, the segmental lordosis angle, the disc height and the range of motion in the operated level were measured.


RESULTS
Postoperatively a significant increase was observed for the following parameters: the anterior (pre: 9.0 +/- 3.4 mm; post: 16.7 +/- 2.4 mm; p < 0.001) and posterior (pre: 4.4 +/- 1.3 mm; post: 8.8 +/- 1.3 mm; p < 0.001) disc height and the segmental lordosis angle (pre: 20 degrees +/- 7.2 degrees; post: 27.7 degrees +/- 7.4 degrees; p < 0.001). Statistically no significant changes could be observed postoperatively for the total lumbar lordosis (pre: 56.2 degrees +/- 10.7 degrees; post: 58.6 degrees +/- 9.3 degrees; p = 0.196) and the range of motion (pre: 5.0 degrees +/- 4.0 degrees; post: 5.9 degrees +/- 3.5 degrees; p = 0.293).


CONCLUSIONS
Total disc replacement for degenerative disc disease of the lumbar spine with the current concept does not alter the range of motion but significantly increases the disc height. The significant increase in segmental lordosis without a change in the total lumbar lordosis accounts for a change in lordosis in adjacent segments.
Cakir
B
B
Orthopädische Abteilung des Rehabilitationskrankenhauses Ulm, Orthopädische Klinik mit Querschnittgelähmtenzentrum der Universität Ulm.
Schmidt
R
R
Huch
K
K
Puhl
W
W
Richter
M
M
D000328:Adult; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D007593:Joint Instability / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D007595:Joint Prosthesis; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D011859:Radiography; D016059:Range of Motion, Articular; D018570:Risk Assessment / Q000379:methods; D016896:Treatment Outcome