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Clinical outcomes after treatment with disc prostheses in three lumbar segments compared to one- or two segments.

Svante Berg, MD, PhD,1 Nina Gillberg-Aronsson, Med stud.2

1Stockholm Spine Center, Löwenströmska Hospital, Stockholm, Sweden, 2Medical School, Karolinska Institutet, Stockholm, Sweden



Fusion surgery in the rare patients suffering from symptomatic degenerative disc disease (DDD) at three segments has been reported to produce poor results and a high frequency of complications, why patients suffering from DDD at three segments are seldom offered surgical treatment.


To compare clinical outcome after one- and two years, between patients that have undergone disc replacement surgery (TDR) at three segments and patients that have been treated at less segments.


The present study is based on data recorded in the Swedish Spine Registry (SweSpine). The study group consisted of 30 patients who underwent three-segment TDR, the comparative group of 700 patients treated in one or two segments. Analyses included comparisons of preoperative data, postoperative results and improvement from baseline.


Our results showed no differences in outcome between groups at one- and two years postoperatively. Improvements achieved after surgery in both groups well exceeded established values for minimally clinically important difference (MCID).


The results of this study show that patients with a diagnosis of therapy-resistant chronic low back pain (CLBP) due to DDD in one, two or even three lumbar segments achieve similar and good results after TDR surgery.

Clinical relevance

The rare patients with severe and convincing DDD from three segments might in carefully selected cases be offered surgery, with a reasonable chance of a beneficial outcome.

register study, Low Back Pain, disc degeneration, total disc replacement, three segments, treatment outcome
Volume 9 Article 49