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Lumbar Total Disc Replacement Leads To Increased Subsequent Facet Injections Compared To Anterolateral Lumbar Interbody Fusions – Lumbar Disc Replacement

The article presents a retrospective matched cohort study comparing the usage of therapeutic lumbar facet injections as a measure of symptomatic facet arthrosis following single-level, stand-alone lumbar total disc replacement (TDR) versus anterolateral lumbar interbody fusion (ALIF/LLIF). The study found that patients who underwent TDR received significantly more facet injections, indicating a greater progression of symptomatic facet arthrosis compared to ALIF/LLIF. Despite this, TDR did not show any protective effect against reoperations when compared to ALIF/LLIF. The findings suggest the need for further research and considerations when choosing the appropriate surgical intervention for patients with lumbar degenerative disc disease

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised spinal hospital on Harley Street UK

Published article

Compared with ALIF/LLIF, patients who underwent TDR received significantly more facet injections, suggesting a greater progression of symptomatic facet arthrosis. TDR was not protective against reoperations compared to ALIF/LLIF.

Lumbar Disc Replacement Surgery Expert. Best Spinal Surgeon UK
Abstract Study design: Retrospective Matched Cohort. Objective: Despite known consequences to the facet joints following lumbar total disc replacement (TDR), there is limited data on facet injection usage for persistent postoperative pain. This study uses real-world data to compare the usage of therapeutic lumbar facet injections as a measure of symptomatic facet arthrosis following single-level,

Abstract

Study design: Retrospective Matched Cohort.

Objective: Despite known consequences to the facet joints following lumbar total disc replacement (TDR), there is limited data on facet injection usage for persistent postoperative pain. This study uses real-world data to compare the usage of therapeutic lumbar facet injections as a measure of symptomatic facet arthrosis following single-level, stand-alone TDR vs anterolateral lumbar interbody fusion (ALIF/LLIF).

Methods: The PearlDiver database was queried for patients (2010-2021) with lumbar degenerative disc disease who received either a single-level, stand-alone TDR or ALIF/LLIF. All patients were followed for ≥2 years and excluded if they had a history of facet injections or spinal trauma, fracture, infection, or neoplasm. The two cohorts were matched 1:1 based on age, sex, insurance, year of operation, and medical comorbidities. The primary outcome was the use of therapeutic lumbar facet injections at 1-, 2-, and 5-year follow-up. Secondary outcomes included subsequent lumbar surgeries and surgical complications.

Results: After 1:1 matching, each cohort had 1203 patients. Lumbar facet injections occurred significantly more frequently in the TDR group at 1-year (6.07% vs 1.66%, P < .0001), 2-year (8.40% vs 3.74%%, P < .0001), and 5-year (11.47% vs 6.40%, P < .0001) follow-up. 5-year injection-free probability curves demonstrated an 87.1% injection-free rate for TDR vs 92.9% for ALIF/LLIF. There was no clinical difference in the incidence of subsequent lumbar surgeries or complications.

Compared with ALIF/LLIF, patients who underwent TDR received significantly more facet injections, suggesting a greater progression of symptomatic facet arthrosis. TDR was not protective against reoperations compared to ALIF/LLIF.

Keywords: facet arthrosis; facet joint; injection; lumbar total disc replacement; reoperation; surgical complication.

The London Spine Unit : most specialised spinal hospital on Harley Street UK

Read the original publication:

Lumbar Total Disc Replacement Leads to Increased Subsequent Facet Injections Compared to Anterolateral Lumbar Interbody Fusions

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Abstract Study design: Retrospective Matched Cohort. Objective: Despite known consequences to the facet joints following lumbar total disc replacement (TDR), there is limited data on facet injection usage for persistent postoperative pain. This study uses real-world data to compare the usage of therapeutic lumbar facet injections as a measure of symptomatic facet arthrosis following single-level

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