Lumbar disc replacement surgery—successes and obstacles to widespread adoption

doi:10.1007/s12178-017-9397-4

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Lumbar disc replacement surgery has shown satisfactory long-term results, but implantation rates in the USA have not increased in the last decade due to strict indications, challenging surgical techniques, and fear of late complications.

Lumbar disc replacement surgery—successes and obstacles to widespread adoption

Published Mar 21, 2017 · S. Salzmann, N. Plais, J. Shue

Current Reviews in Musculoskeletal Medicine

67

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Abstract

Purpose of reviewLumbar disc replacement has been a surgical alternative to fusion surgery for the treatment of lumbar degenerative disc disease (DDD) for many years. Despite enthusiasm after the approval of the first devices, implantation rates have remained low, especially in the USA. The goal of this review is to provide a general overview of lumbar disc replacement in order to comprehend the successes and obstacles to widespread adoption.Recent findingsAlthough a large amount of evidence-based data including satisfactory long-term results is available, implantation rates in the USA have not increased in the last decade. Possible explanations for this include strict indications for use, challenging surgical techniques, lack of device selection, fear of late complications or revision surgeries, and reimbursement issues.SummaryRecent publications can address some of the past concerns, but there still remain obstacles to widespread adoption. Upcoming data on long-term outcome, implant durability and possible very late complications will determine the future of lumbar disc replacement surgery.

Study Snapshot

Key takeawayLumbar disc replacement surgery has shown satisfactory long-term results, but low implantation rates in the USA may be due to strict indications, challenging techniques, device selection, fear of complications, and reimbursement issues.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

Lumbar disc replacement surgery has shown satisfactory long-term results, but implantation rates in the USA have not increased in the last decade due to strict indications, challenging surgical techniques, and fear of late complications.

Lumbar disc replacement surgery—successes and obstacles to widespread adoption

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