Artificial nucleus replacement: surgical and clinical experience

Abstract

Objective: To assess long-term clinical results of prosthetic disc nucleus (PDN) replacement for the treatment of lumbar disc herniation. Methods: Seventy-two patients with lumbar disc herniation were implanted with a single PDN device from March 2002 to December 2003. Fifty-eight (80.6%) patients attended clinical, functional, and radiographic follow-up examinations for more than 48 months. Independent analysis was performed by careful review of the interviews, operative reports, preoperative and postoperative radiographs, and computed tomography scans or magnetic resonance imaging (MRI). Results: After implantation, a significant proportion of patients experienced pain relief. Improvements were noted in pain intensity, walking distance, neurological weakness, Oswestry and Prolo scores, intervertebral disc height and lumbar mobility. Intervertebral disc height was not well maintained, compared with the preoperative height it decreased 18% (P < 0.001). Several complications were associated with the implantation of PDN, including transient low-back pain, implant dislocation, malposition of the implant, damage to the end plates and subsidence of implant. Conclusion: The clinical data show that PDN is preferred and can effectively increase the range of lumbar motion in patients with lumbar disc herniation. However, this study only represents cases in our centre.