Long-term outcomes of total lumbar disc prosthesis: Sustained pain relief

Abstract

Background

Lumbar degenerative disc disease (DDD) is a leading cause of chronic low back pain and work-related disability. Total lumbar disc prosthesis offers motion preservation and may reduce adjacent segment degeneration compared to fusion. However, long-term functional and occupational outcomes remain underreported.

Methods

This retrospective cohort study included 130 patients (mean age 37.3±7.9 years; 71.54% male) who underwent total lumbar disc replacement between 2008 and 2020. Patients were assessed preoperatively and at a mean follow-up of 13.88 years using Visual Analog Scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and occupational status. Statistical analyses included ANOVA, regression modeling, and correlation analysis.

Results

VAS scores improved significantly (back: 8.6±1.7 to 1.6±2.4; leg: 7.3±2.9 to 1.1±0.9; p<.001). ODI decreased from 46.12±7.3 to 27±9.3. At final follow-up, 73.84% of patients returned to their original job, 13.84% transitioned to alternative roles, and 3.07% were pensioned. Patient satisfaction was high (77.69% rated outcome as 10/10). Complication and reoperation rates were low (3.08% and 12.31%, respectively), with no prosthesis revisions.

Conclusions

Total lumbar disc prosthesis provides durable pain relief, functional improvement, and high rates of occupational reintegration. These findings support its use as a motion-preserving alternative to fusion in appropriately selected patients.