Relationship of surgical accuracy and clinical outcomes in Charitè lumbar disc replacement

Objective: To retrospectively assess the clinical and functional outcomes of a group of patients receiving Charitè lumbar disc replacement and to compare those outcomes to the corresponding surgical technical accuracy.

Methods: A retrospective study of all patients treated over a 3-year period was undertaken. Objective pain scores were quantified from 1 to 10. Short Form 36-Health Survey (SF-36v2) scores were compared to Australian population norms. Surgical placements were radiographically classified. Heterotopic ossification, disc height restoration and angle-defined instability were assessed using established protocols.

Results: Twenty-five patients were identified with three patients lost to follow-up. Average follow-up was 34 months. Ideal surgical placement was achieved in five (33%) single-level and three (37.5%) dual-level disc replacements. Sub-optimal surgical placement was seen in nine (60%) single-level and five (62.5%) dual-level disc replacements. Poor surgical placement was observed in a single-level disc replacement. All patients demonstrated a reduction in objective pain score (P < 0.05). SF-36v2 outcomes were superior in single-level compared to dual-level and ideal compared to sub-optimal replacements (P < 0.05).

Conclusion: The hypothesis that ideal surgical placements are associated with improved clinical and functional outcomes in total lumbar disc replacement was confirmed.