Abstract:
STUDY DESIGN:Analysis of segmental and total lumbar range of motion (ROM) before and after total lumbar disc replacement. OBJECTIVE:To examine the relationship between absolute segmental and total lumbar ROM and evolution of ROM on clinical outcome. SUMMARY OF BACKGROUND DATA:At the moment, data are scarce with regard to the evolution of total lumbar ROM (t-ROM) and segmental ROM (s-ROM) after total lumbar disc replacement. Moreover, the influence of ROM on clinical outcome still is unclear and remains a matter of controversial debate. METHODS.: Forty patients operated on for mono- or bisegmental symptomatic degenerative disc disease with a total of 45 artificial discs (ProDisc-L, Synthes) were analyzed. Pre- and postoperative s-ROM and t-ROM were measured on flexion/extension radiographs. The Oswestry Low Back Pain Disability Questionnaire and the Short Form 36 Health Survey were obtained pre- and postoperatively with a minimum follow-up of 3 years (37-64 months). RESULTS:Neither the s-ROM (pre-/postoperatively: 6.9 degrees/7.3 degrees) nor the t-ROM (pre-/postoperatively: 34.9 degrees/35.8 degrees) did change significantly after implantation of an artificial disc. Postoperatively, there was an increase of s-ROM (t-ROM) in 40% (40%), a decrease in 35% (30%), and no change in 25% (30%) of the patients. A significant inferior clinical outcome only was observed in patients with decreased t-ROM. The resulting postoperatively s-ROM had no significant impact on outcome. CONCLUSION:Neither the absolute s-ROM nor the evolution of s-ROM (increase, decrease, unchanged) was positively correlated with better clinical outcome. Although a positive correlation was observed with regard to t-ROM.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Cakir B,Schmidt R,Mattes T,Fraitzl CR,Reichel H,Käfer Wdoi
10.1097/BRS.0b013e31819b213csubject
Has Abstractpub_date
2009-04-20 00:00:00pages
917-23issue
9eissn
0362-2436issn
1528-1159pii
00007632-200904200-00010journal_volume
34pub_type
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