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European Spine Journal

, Volume 23, Issue 10, pp 2114–2126 | Cite as

Five-year results of lumbar disc prostheses in the SWISSspine registry

  • Emin Aghayev
  • Christian Etter
  • Christian Bärlocher
  • Friedrich Sgier
  • Philippe Otten
  • Paul Heini
  • Oliver Hausmann
  • Gianluca Maestretti
  • Martin Baur
  • François Porchet
  • Thomas M. Markwalder
  • Stefan Schären
  • Michal Neukamp
  • Christoph Röder
Original Article

Abstract

Purpose

The Swiss Federal Office of Public Health demanded a nationwide HTA registry for lumbar total disc arthroplasty (TDA), to decide about its reimbursement. The goal of the SWISS spine registry is to generate evidence about the safety and efficiency of lumbar TDA.

Methods

Two hundred forty-eight cases treated between 3-2005 and 6-2006, who were eligible for the 5-year follow-up were included in the study. Follow-up rates for 3–6 months, 1, 2 and 5 years were 85.9, 77.0, 44.0 and 51.2 %, respectively. Outcome measures were back and leg pain, medication consumption, quality of life, intraoperative and postoperative complication and revision rates. Additionally, segmental mobility, ossification, adjacent and distant segment degeneration were analysed at the 5-year follow-up.

Results

There was a significant, clinically relevant and lasting reduction of back (preop/postop 73/29 VAS points) and leg pain (preop/postop VAS 55/22) and a consequently decreased analgesics consumption and quality of life improvement (preop/postop 0.30/0.76 EQ-5D score points) until 5 years after surgery. The rates for intraoperative and early postoperative complications were 4.4 and 3.2 %, respectively. The overall complication rate during five postoperative years was 23.4 %, and the adjacent segment degeneration rate was 10.7 %. In 4.4 % of patients, a revision surgery was performed. Cumulative survivorship probability for a revision/re-intervention-free 5-year postoperative course was 90.4 %. At the 5-year follow-up, the average range of motion of the mobile segments (86.8 %) was 9.7°. In 43.9 % of patients, osteophytes at least potentially affecting the range of motion were seen.

Conclusions

Lumbar TDA appeared as efficient in long-term pain alleviation, consequent reduction of pain medication consumption and improvement of quality of life. The procedure also appeared sufficiently safe, but surgeons have to be aware of a list of potential adverse events. The outcome is stable over the 5-year postoperative period. The vast majority of treated segments remained mobile after 5 years, although almost half of patients showed osteophytes.

Keywords

SWISSspine TDA Disc arthroplasty Lumbar disc prosthesis Long-term follow-up 

Notes

Acknowledgments

The authors are thankful to the SWISSspine registry group who made this research possible by populating the database with their valuable and much appreciated entries. Among others, data of the following colleagues were used in the study: Etter C (n = 26), Bärlocher C (n = 24), Sgier F (n = 24), Huber J (n = 17), Otten P (n = 15), Heini P (n = 13), Hausmann O (n = 12), Maestretti G (n = 11), Baur M (n = 9), Porchet F (n = 9), Markwalder T (n = 8), Renella R (n = 8), Schaeren S (n = 6), Self T (n = 6), Schwarzenbach O (n = 5), Kast E (n = 4), Kleinstück F (n = 4), Lattig F (n = 4), Min K (n = 4), Schizas C (n = 4), Berlemann U (n = 3), Grob D (n = 3), Hasdemir M (n = 3), Marchesi D (n = 3), Aebi M (n = 2), Binggeli R (n = 2), Boscherini D (n = 2), Favre J (n = 2), Forster T (n = 2), Jeanneret B (n = 2), Moulin P (n = 2), Tessitore E (n = 2), Boos N (n = 1), Cathrein P (n = 1), Kroeber M (n = 1), Payer M (n = 1), Ramadan A (n = 1), Stoll T (n = 1), Wernli F (n = 1). Funded by the AO Foundation start-up-grant S-10-41A.

Conflict of interest

None.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Emin Aghayev
    • 1
  • Christian Etter
    • 2
  • Christian Bärlocher
    • 3
  • Friedrich Sgier
    • 4
  • Philippe Otten
    • 5
  • Paul Heini
    • 6
  • Oliver Hausmann
    • 4
  • Gianluca Maestretti
    • 7
  • Martin Baur
    • 8
  • François Porchet
    • 9
  • Thomas M. Markwalder
    • 10
  • Stefan Schären
    • 11
  • Michal Neukamp
    • 1
  • Christoph Röder
    • 1
  1. 1.Institute for Evaluative Research in MedicineBernSwitzerland
  2. 2.Hirslanden ClinicAarauSwitzerland
  3. 3.Stephanshorn HospitalSt. GallenSwitzerland
  4. 4.St. Anna ClinicLucerneSwitzerland
  5. 5.FribourgSwitzerland
  6. 6.Sonnenhof ClinicBernSwitzerland
  7. 7.Cantonal Hospital of FribourgFribourgSwitzerland
  8. 8.Cantonal Hospital of LuzernLucerneSwitzerland
  9. 9.Schulthess ClinicZurichSwitzerland
  10. 10.Hirslanden Clinic, Salem-SpitalBernSwitzerland
  11. 11.University Hospital of BaselBaselSwitzerland

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