Artificial Total Disc Replacement for Lumbar Degenerative Disc Disease: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

HE Zu sheng ¹ , BAI Jing ping ² , XILIN Bao le ri ³ , JIN Ge le ⁴ , WU Tai xiang ⁵ , LI Jing ⁵

1 Xinjiang Medical University; Urimqi 830054; China2 The Third Affiliated Hospital of Xinjiang Medical University; Urimqi 8300113 The Second Affiliated Hospital of Xinjiang Medical University; Urimqi 8300284 The First Affiliated Hospital of Xinjiang Medical University5 Evidence Based Medicine and Clinical Epidemiology Center; West China Hospital;

Corresponding author：

Keywords：

Artificial disc; Lumbar disc disease degenerative therapy; Systematic review

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Objective 　To evaluate the efficacy of artificial total disc replacement for lumbar degenerative disc disease compared with lumbar fusion and other treatment.
Methods 　We conducted electronic searching on The Cochrane Library (Issue 2, 2004) and Specialized Trials Register of Cochrane Back Group, MEDLINE (1966 to 2004)，EMBASE (1980 to 2004) and CBMdisk (2003), some Chinese Journals were handsearched, and researchers in the field were contacted. Data were extracted and evaluated by two reviewers independently. The quality evaluation of studies and data analysis followed the methods of The Cochrane Collaboration.
Results 　Three studies including 152 patients met the inclusion criteria. Two studies used ProDisc Ⅱ, while the other one used SB-Ⅲ. The patients who received the disc replacement reported reduced pain and improved function in early postoperative period, better satisfaction rates at month 6 post operation; complications of operation were reported in two randomized controlled trials.
Conclusions 　The quality of the included trials is inadequate to draw any conclusion about the efficacy of artificial total disc replacement. More trials with high quality on methodology are needed. Artificial discs could preserve motion of diseased level in the short term. Protection of adjacent levels can only be assessed when large studies with long term follow-up are conducted.

Citation： HE Zu sheng,BAI Jing ping,XILIN Bao le ri,JIN Ge le,WU Tai xiang,LI Jing. Artificial Total Disc Replacement for Lumbar Degenerative Disc Disease: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2005, 05(2): 136-139. doi: Copy

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1. Folman Y, Lee SH, Silivera JR, Gepstein R. Posterior lumbar interbody fusion for degenerative disc disease using a minimaly invasive B-Twin expandable spinal spacer: a multicenter study[J]. Spinal Disorder&techniques, 2003;16(5): 455-460.
2. Chedid KJ, Chedid MK. The "tract" of history in the treatment of lumbar degenerative disc disease[J]. Neurosurg Focus, 2003;16(1): 1-4.
3. Hall BB, Asher MA, Zang RH, Quinn LM. The safety and efficacy of the isola spinal implant system for the surgical treatment of degenerative disc disease: d prospective study[J]. Spine, 1996;21(8): 982-994.
4. Jack EZ, Paul AA, Scott DB, Keith HB, Alexander RV. What is New in Spine Surgery in Spine Surgery[J]. The Journal Of Bone And Joint Surgery, 2003;85(8): 1 626-1 636.
5. Herkowitz HN, Abraham DJ, Albert TJ. Management of degenerative disc disease above an L5-S1 segment requiring arthrodesis [Controversy] [J]. Spine, 1999;24(12): 1 268.
6. QI BB, Hansen AY. Artificial disc technology[J]. Neurosurg Focus, 2000;9(4): 1-7.
7. Fritzell P, Hagg O, Wessberg P, Nordwall A .Lumbar fusion versus nonsurgical treatment for chronic low back pain: a multicenter randomized controlled trial from the Swedish Lumbar Spine Study Group[J]. Spine, 2001;26(23): 2 521-2 534.
8. Resnick DK. Spinal Fusion for Discogenic Back Pain: Patient Selection, Operative Techniques, and Outcomes[J]. Techniques in Neurosurgery, 2003;8(3): 176-190.
9. Heary, Robert F. Intradiscal Electrothermal Annuloplasty: The IDET Procedure[J]. Journal of Spinal Disorders, 2001;14(4): 353-360.
10. Delamarter RB, Fribourg DM, Kanim LE, Bae H. ProDisc Artificial Total Lumbar Disc Replacement: Introduction and Early Results From the United States Clinical Trial[J]. Spine, 2003;28(20s): s167-s175.
11. Zigler JE. Clinical Results with ProDisc: European Experience and U.S. Investigation Device Exemption Study[J]. Spine, 2003;28(20s): s163-s166.
12. Cunningham BW, Gordon JD, Dmitriev AE, Hu NB, McAfee PC. Biomechanical Evaluation of Total Disc Replacement Arthroplasty: An In Vitro Human Cadaveric Model[J]. Spine, 2003;28(20s): s110-s117.
13. McCullen GM, Yuan HA. Artificial disc: current developments in artificial disc replacement[J]. Current Opinion in Orthopaedics, 2003;14(3): 138-143.
14. Juni P, Altman DG, Egger M. Assessing the quality of controlled clinical trials[J]. BMJ, 2001;323(7 303): 42-46.
15. McAfee PC, Fedder IL, Saiedy S, Shucosky EM, Cunningham BW. SB-Charité Disc Replacement: Report of 60 Prospective Randomized Cases in a U.S. Center[J]. J Spinal Disord Tech J Spinal Disord Tech, 2003;16(4): 424-433.

Chinese Journal of Evidence-Based Medicine

Artificial Total Disc Replacement for Lumbar Degenerative Disc Disease: A Systematic Review

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