Lumbar Total Disk Replacement Device Removals and Revisions Performed During a 20-Year Experience with 2141 Patients
![](https://cuellarspine.com/wp-content/uploads/2023/05/cuellar-featured-svg.png)
Study Design
This was a retrospective study with prospective patient contact attempted to collect current data.
Objective
The purpose was to investigate the incidence and reasons for lumbar total disk replacement (TDR) removal or revision.
Summary of Background Data
A concern regarding lumbar TDR was safety, particularly the need for device removal or revision. This may be particularly important considering removal/revision requires repeat anterior exposure with an increased risk of vascular injury.
Methods
Data were collected for a series of 2141 lumbar TDR patients, beginning with the first case experience in 2000. The mean follow-up was 78.6 months. For each case of device removal/revision, the reason, duration from index surgery, and procedure performed were recorded.
Results
Of 2141 patients, 27 (1.26%) underwent TDR removal or revision. Device removal was performed in 24 patients (1.12%), while three patients underwent revision (0.14%). Of the 24 removals, 12 were due to migration and/or loosening, three developed problems post-trauma, two developed lymphocytic reaction to device materials, two had ongoing pain, and there was one case of each: TDR was too large, vertebral body fracture (osteoporosis), lytic lesion, device subsidence and facet arthrosis, and infection seeded from a chest infection 146 months post-TDR. The three revisions were for Core repositioning (technique error), device repositioning after displacement, and core replacement due to wear/failure. With respect to timing, 37.0% of removals/revisions occurred within one-month postimplantation. Of note, 40.7% of removals/revisions occurred in the first 25 TDR cases performed by individual surgeons. There was one significant vascular complication occurring in a patient whose TDR was removed due to trauma. This was also the only patient among 258 with ≥15-year follow-up who underwent removal/revision.
Conclusion
In this large consecutive series, 1.26% of TDRs were removed/revised. The low rate over a 20 year period supports the safety of these devices.
More News & Insights from Cuéllar Spine
Exploring the Success Rates and Benefits of Laminectomy Without Fusion Surgery
Lumbar disc replacement surgery offers a promising alternative to traditional treatments for debilitating back pain and limited mobilit
The State of Outpatient Spine Surgery in 4 Studies
Outpatient spine surgery is growing, and its outlook suggests the trend will likely continue. Here are four studies illustrating the st
The Pros and Cons of Lumbar Disc Replacement (Also known as Total Disc Replacement (TDR), Total Disc Arthroplasty (TDA), or Artificial Disc Replacement (ADR))
Lumbar disc replacement surgery offers a promising alternative to traditional treatments for debilitating back pain and limited mobilit
10 Signs You May Need Revision Spine Surgery
Revision spine surgery, also known as secondary spine surgery, plays a crucial role in addressing persistent or recurrent spinal condit
Lumbar Total Disk Replacement Device Removals and Revisions Performed During a 20-Year Experience with 2141 Patients
This was a retrospective study with prospective patient contact attempted to collect current data.
36-Year-Old Male with History of Neck Pain
36-Year-Old Male with History of Neck Pain Radiating Into Both Shoulders, Numbness in Radial 3 Fingers of Both Hands
Problems with Artificial Disc Replacement
Artificial disc replacement (ADR), also known as total disc replacement (TDR), has emerged as a revolutionary approach in the field of
Top 5 Ways a Spinal Surgeon Can Help with Neck Pain
It is easy to take the movement in our necks for granted - and yet, when we are in pain, our neck flexibility can become extremely limi
ADR Spine Announces the Inclusion of Four Surgeons to Its National Top Doctors in Arthroplasty Program
ADR Spine Welcomes Elite Physicians to Top Doctors in Arthroplasty Program