Degeneration Similar With, Without Disc Prosthesis Surgery

No difference in development of adjacent level degeneration; facet arthropathy up post-surgery

WEDNESDAY, Dec. 12 (HealthDay News) -- Compared with rehabilitation, disc prosthesis surgery for chronic low back pain is associated with the same level of adjacent level degeneration (ALD) but with increased facet arthropathy (FA) at the implant level, according to a study published in the Dec. 1 issue of Spine.

Christian Hellum, M.D., of the University of Oslo in Norway, and colleagues conducted a randomized clinical trial that followed 116 patients with a history of low back pain over a two-year period to assess the development of ALD and index level FA in patients who either underwent disc prosthesis surgery or were treated with rehabilitation alone.

The researchers found that the incidence of ALD development was the same, regardless of whether patients received a disc prosthesis or rehabilitation. Index level FA appeared or increased in 34 percent of patients who were treated with surgery, compared with only 4 percent who received rehabilitation. Clinical outcome was not related to development of ALD or FA.

"ALD incidence at a two-year follow-up was similar in patients treated with the disc prostheses and patients treated without surgery, but the former group had increased index level FA," the authors write. "The potential advantage of low risk of accelerated ALD with a disc prosthesis must be weighed against the increased risk of index level FA, particularly in L5-S1."

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