PMID- 34559766
OWN - NLM
STAT- MEDLINE
DCOM- 20220209
LR  - 20231020
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Print)
IS  - 0362-2436 (Linking)
VI  - 47
IP  - 5
DP  - 2022 Mar 1
TI  - Comparison of Mid- to Long-term Follow-up of Patient-reported Outcomes Measures 
      After Single-level Lumbar Total Disc Arthroplasty, Multi-level Lumbar Total Disc 
      Arthroplasty, and the Lumbar Hybrid Procedure for the Treatment of Degenerative 
      Disc Disease.
PG  - 377-386
LID - 10.1097/BRS.0000000000004253 [doi]
AB  - STUDY DESIGN: Prospective cohort study. OBJECTIVE: The aim of this article is to 
      compare the mid- to long-term patient-reported outcome measures (PROMs) between 
      single-level total disc arthroplasty (TDA), multi-level TDA, and hybrid 
      constructs (combination of TDA and anterior lumbar interbody fusion [ALIF] across 
      multiple levels) for symptomatic degenerative disc disease (DDD). SUMMARY OF 
      BACKGROUND DATA: The treatment of single-level DDD is well documented using TDA. 
      However, there is still a paucity of published evidence regarding long-term 
      outcomes on multi-level TDA and hybrid constructs for the treatment of 
      multi-level DDD, as well as lack of long-term comparisons regarding treatment of 
      single-level DDD and multi-level DDD. METHODS: A total of 950 patients underwent 
      surgery for single-level or multi-level DDD between July 1998 and February 2012 
      with single-level TDA (n = 211), multi-level TDA (n = 122), or hybrid construct 
      (n = 617). Visual Analog Score for the back (VAS-B) and leg (VAS-L) were 
      recorded, along with the Oswestry Disability Index (ODI) and Roland Morris 
      Disability Questionnaire (RMDQ). RESULTS: All PROMs in all groups showed 
      statistically and clinically significant improvements (P < 0.005) in pain and 
      function that is well above the corresponding minimum clinically important 
      difference (MCID) and exceeds literature thresholds for substantial clinical 
      benefit (SCB). Unadjusted analyses show that there were no statistically 
      significant differences in the change scores between the surgery groups for VAS 
      back and leg pain, and RMDQ up to 8 years' follow-up. Adjusted analyses showed 
      the ODI improvement score for the single group was 2.2 points better (95% 
      confidence interval [CI]: 0.6-3.9, P = 0.009) than in the hybrid group. The RMDQ 
      change score was better in the hybrid group than in the multi-level group by 1.1 
      points (95% CI: 0.4-1.9, P = 0.003) at 6 months and a further 0.4 point at 
      2 years (95% CI: 0.1-0.8, P = 0.011). CONCLUSION: In the setting of meticulous 
      preoperative evaluation in establishing a precision diagnosis, clinically and 
      statistically equivalent results can be achieved when treating symptomatic DDD 
      through single-level TDA, multi-level TDA, and hybrid constructs. These results 
      are sustained at mid- to long-term follow-up.Level of Evidence: 3.
CI  - Copyright (c) 2021 The Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Scott-Young, Matthew
AU  - Scott-Young M
AD  - Gold Coast Spine, Gold Coast, Queensland, Australia.
AD  - Faculty of Health Science & Medicine, Bond University, Gold Coast, Queensland, 
      Australia.
FAU - Lee, So Mang Simon
AU  - Lee SMS
AD  - Gold Coast Spine, Gold Coast, Queensland, Australia.
FAU - Nielsen, David
AU  - Nielsen D
AD  - Department of Orthopedic Surgery, Princess Alexandra Hospital, Brisbane, 
      Queensland, Australia.
FAU - Rathbone, Evelyne
AU  - Rathbone E
AD  - Faculty of Health Science & Medicine, Bond University, Gold Coast, Queensland, 
      Australia.
FAU - Rackham, Matthew
AU  - Rackham M
AD  - Gold Coast Spine, Gold Coast, Queensland, Australia.
FAU - Hing, Wayne
AU  - Hing W
AD  - Faculty of Health Science & Medicine, Bond University, Gold Coast, Queensland, 
      Australia.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Follow-Up Studies
MH  - Humans
MH  - *Intervertebral Disc Degeneration/surgery
MH  - Lumbar Vertebrae/surgery
MH  - Pain Measurement
MH  - Patient Reported Outcome Measures
MH  - Prospective Studies
MH  - *Spinal Fusion
MH  - *Total Disc Replacement
MH  - Treatment Outcome
PMC - PMC8815823
EDAT- 2021/09/25 06:00
MHDA- 2022/02/10 06:00
PMCR- 2022/02/04
CRDT- 2021/09/24 17:16
PHST- 2021/09/25 06:00 [pubmed]
PHST- 2022/02/10 06:00 [medline]
PHST- 2021/09/24 17:16 [entrez]
PHST- 2022/02/04 00:00 [pmc-release]
AID - 00007632-202203010-00001 [pii]
AID - SPINE163929 [pii]
AID - 10.1097/BRS.0000000000004253 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2022 Mar 1;47(5):377-386. doi: 
      10.1097/BRS.0000000000004253.