Turkish Neurosurgery 2009 , Vol 19 , Num 2
Total Disc Replacement in the Treatment of Lumbar Discogenic Pain with Disc Herniation: A Prospective Clinical Study
Mehdi SASANİ1, Tunç ÖKTENOĞLU2, Kaner TUNCAY3, Nazan CANBULAT4, Şenol CARİLLİ5, Fahir A. ÖZER6
1,2,6VKV American Hospital, Neurosurgery Department, Istanbul, Turkey
3Pendik State Hospital, Neurosurgery Department, Istanbul, Turkey
4VKV American Hospital, Physical Therapy and Rehabilitation Department, Istanbul, Turkey
5VKV American Hospital, General Surgery Department, Istanbul, Turkey
BACKGROUND: Biomechanical benefits of Total Disc Replacement (TDR) including both the restoration of normal segmental range of motion and the prevention of physiological lumbar lordosis encourage spine surgeons to perform TDR for lumbar disc disease.

METHODS: Atotal of twenty patients (mean age: 39.5) who had degenerative disc disease with unilateral disc herniation were operated on between 2003 and 2006. Microscopic anterior lumbar discectomy with TDR placement via a transperitoneal approach were performed. Each patient was evaluated using a VAS and the Oswestry index.

RESULTS: Mean ODI improved from 73.3 preoperatively to 35.0 and 20.4 at 3 and 12 months of follow-up respectively (P < 0.001). The mean VAS score improved from 8.65 preoperatively to 2.6 and 1.9 at 3 and 12 months respectively (P < 0.001).

CONCLUSIONS: Results from this series are promising and indicate that placement of TDR for degenerative disc disease with lumbar disc herniation is a valuable alternative to conventional techniques. The main advantages of this application are preservation of spinal stability, early mobilization, restoration of normal segmental range of motion and elimination of problems related to intervertebral disc tissue such as discogenic pain and recurrence of disc herniation. Keywords : Lumbar spine, İntervertebral disc, Artificial disc placement, Discogenic pain, Lumbar disc herniation

Corresponding author : Mehdi Sasani, sasanim@gmail.com