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Few Indications Seen for Total Disc Replacement

It is unlikely that total disc replacement will replace spinal fusion, researcher concludes

FRIDAY, Aug. 31 (HealthDay News) -- In the overall population of patients presenting with discogenic low back pain, there is an extremely low incidence of indications for total disc replacement, according to a report published in the July/August issue of the Spine Journal.

Kingsley R. Chin, M.D., of the University of Pennsylvania in Philadelphia, studied 627 patients who were evaluated by an orthopedic spine surgeon. Of the 131 patients who subsequently underwent lumbar surgeries, 57 had fusions and 74 had non-fusion surgeries.

In the entire group of patients, Chin found an incidence of 0.5 percent of indications for total disc replacement. In the fusion-surgery group, he found that the prevalence of no contraindications to total disc replacement was 5 percent. In the non-fusion group, he also found that 71 (96 percent) of patients were satisfied with laminectomies and laminotomies.

"Although it was anticipated by industry and venture capitalists that total disc replacement will replace spinal fusion for discogenic low back pain, it is unlikely that other disorders currently treated with spinal fusion will be replaced by total disc replacement, especially in patients older than 65 years," the author writes. "It is hoped that the data in this study will provide some guide as to the expectations for the pool of patients indicated for total disc replacement surgery and that there will be greater emphasis on indications and patient selection more so than on technique and economics," the author concludes.

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