title: Clinical outcome of lumbar total disc replacement using ProDisc-L in degenerative disc disease: minimum 5-year follow-up results at a single institute.
abstract: METHODS
  A retrospective clinical data analysis.
  
  
  OBJECTIVE
  To determine the therapeutic effectiveness of lumbar total disc replacement (TDR) using ProDisc-L (Synthes Spine, West Chester, PA) in the patients with degenerative disc diseases (DDD) with a minimum follow-up of 5 years.
  
  
  BACKGROUND
  Early successful clinical results of lumbar TDR have been reported. However, few reports have published its therapeutic effectiveness in the long term.
  
  
  METHODS
  The patients were examined preoperatively and at 3 months, 1 year, 2 years, and more than 5 years postoperatively, and assessed using visual analog scale (VAS), Oswestry disability index (ODI), physical health component summary (PCS) of the 36-Item Short Form Health Survey questionnaire, and sporting activity scale scores. At last follow-up visits, two additional questions were asked: satisfaction with surgery and willingness to undergo the same treatment. Finally, clinical success was assessed using the Food and Drug Administration definition.
  
  
  RESULTS
  Thirty-five patients were included in the study. The mean follow-up period was 72 months (6 years). Postoperatively, all outcome measure scores (VAS, mean ODI, PCS, and sports activity scores) immediately improved and these improvements were maintained at last follow-up visits with statistical significance. However, outcome score improvements were observed to be slightly, though significantly, lower at last follow-up visits than at 1 or 2 years postoperatively. Eighty-eight percent of patients were "satisfied" or "somewhat satisfied" with treatment and 60% were prepared to undergo the same treatment again. Twenty-five patients (71.4%) achieved clinical success.
  
  
  CONCLUSIONS
  This study reveals that lumbar TDR using ProDisc-L is a safe and effective treatment for chronic back pain caused by lumbar DDD as assessed at more than 5 years postoperatively. Nevertheless, outcome scores were slightly, though significantly lower at last follow-up visits than at 1 and 2 years postoperatively. A longer-term follow-up study is warranted.
authors.affiliation: Department of Neurosurgery, Seoul St. Mary Hospital, The Catholic University, Seoul, South Korea.
authors.forename: Chun-Kun
authors.initials: CK
authors.lastname: Park
authors.forename: Kyeong-Sik
authors.initials: KS
authors.lastname: Ryu
authors.forename: Ki-Yeol
authors.initials: KY
authors.lastname: Lee
authors.forename: Hong-Jae
authors.initials: HJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D001416:Back Pain / Q000209:etiology / Q000601:surgery*; D017586:Diskectomy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D059145:Total Disc Replacement / Q000295:instrumentation / Q000379:methods*