Radiological changes after Activ L total disc replacement and its correlation with clinical outcome

English Keywords:Lumar total disc replacement  Outcome  Radiology  Correlation analysis

English Abstract:

  【Abstract】 Objectives: To correlate the radiographic results of patients undergoing Activ L total disc repalcement with clinical outcomes. Methods: From March 2009 to March 2012, 32 patients with degenerative disc disease(DDD) underwent Activ L total disc repalcement, 30 cases(36 prosthesis) of whom received an average follow-up of 28.8 months(range, 12-46 months), 20 of whom with a 2-years follow-up and 15 with a 3-years follow-up. Clinical parameters as visual analogue scale(VAS) and Oswestry disability index(ODI) were evaluated preoperatively and at the final follow-up. Radiographic parameters such as range of motion(ROM), intervertebral disc height(IDH) of the index and adjacent segments, and lumbar lordosis were recorded. Preoperative VAS score, ODI score, ROM, IDH and lumbar lordosis were compared with those at postoperation by using paired t test. The correlation between ROM, IDH and lumbar lordosis were reviewed. Results: The VAS(back pain), VAS(leg pain) and ODI score improved significantly at final follow-up(P＜0.0001). At final follow-up, ROM of the index level and the upper adjacent level showed increase significantly(P＜0.05), while the lower adjacent level remained unchange(P＞0.05). IDH of the index level showed no significant increase at the final follow-up(P＞0.05) compared with that before surgery. The IDH of the upper and lower adjacent level showed no significant difference at final follow-up(P＞0.05). Compared with preoperative data, the lumbar lordosis showed no obvious difference at final follow-up(P＞0.05). At final follow-up, the radiographic parameters were not correlated with clinical results(r＜0.2138, P＞0.05). Conclusions: The short and mid-term results of Activ L prosthesis for degenerative disc diseases are satisfying, and radiographic parameters as ROM, IDH and lumbar lordosis are not correlated with clinical results.