Abstract:

BACKGROUND: The new artificial disc replacement concept was proposed in 1960’s, which attempted to simulate normal human inter-vertebral disc artificial disc to avoid the negative effects of inter-vertebral fusion. However, it remains controversial in term of the efficacy and safety for the two treatments of lumbar degenerative disc disease (DDD).
OBJECTIVE: To assess the effect and the safety of lumbar disc replacement versus fusion for the treatment of DDD.
METHODS: Cochrane Back Group, the Cochrane library (Number 12, 2009), additional electronic database including Medline (1966/2009-12), Embase (1966/2009-12), CBM, CNKI were retrieved for articles of well designed clinical trials related to lumbar disc replacement versus fusion for the treatment of DDD. Chinese Journals were manually searched. Data were extracted and evaluated by two reviewers independently of each other. Among the literature, the test group was treated with artificial disc replacement, while the control group with fusion; The Cochrane Collaboration’s RevMan 4.2.2 software was used for data analyses.
RESULTS AND CONCLUSION: A total of 7 studies were included involving 936 patients. Meta-analysis indicated that no difference was found in mean blood loss mean operation time or re-operation rate between two groups (P > 0.05), but the disc replacement group had lower rate of the complication, better VAS scores and ODI score compared with fusion group (P < 0.05). The disc replacement group show superior clinic efficacy at the immediate postoperative time. However, there is no difference between two groups in safety. More randomized controlled trials with long time and high quality are required for further validation.