Long-term follow-up of total lumbar disc replacement

Total Disc Replacement (TDR) has been introduced as a surgical treatment for patients with chronic low back pain and degeneration of intervertebral discs, for when conservative therapy has not provided sufficient relief. The most commonly performed surgery is the immobilisation of the discs in the spine that are presumed to be causing the pain. However, this puts a lot of strain on the other parts of the back and can lead to wear and tear. In theory, TDRs can continue to move and this can potentially lead to better outcomes for the patient. However, this research does not show this to be the case. In addition, disadvantages of TDRs also became apparent, such as subsidence into the vertebral body. Patients with TDRs who have complaints regularly undergo several re-operations without any evidence being available as to whether these interventions are beneficial. It was found that in 50 per cent of patients re-operation leads to a clear reduction of the complaints, and because of this the TDR does not have to be removed.