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Research ArticleLumbar Spine

Long-Term Outcomes Following Lumbar Nucleus Replacement

Jeff D. Golan, Frederic Martens, Jeff Griebel, David C. LoPresti, Michael G. Hess and Michael Ahrens
International Journal of Spine Surgery December 2021, 15 (6) 1096-1102; DOI: https://doi.org/10.14444/8196
Jeff D. Golan
1 McGill University, Montreal, Canada
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Frederic Martens
2 Department of Neurosurgery, Onze-Lieve-Vrouw Hospital, Aalst, Belgium
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Jeff Griebel
3 Beyond Air Inc, Garden City, New York, USA
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David C. LoPresti
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Michael G. Hess
4 Orthopedic Surgery, London Spine Clinic, London, United Kingdom
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Michael Ahrens
5 c/o SURGITENT GmbH, Hamburg, Germany
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  • Figure 1
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    Figure 1

    (A) DASCOR delivery catheter and implant. (B) PerQdisc delivery device and implant.

  • Figure 2.
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    Figure 2.

    Change in mean (± SEM) back-visual analog scale (VAS) baseline to 1 year for all groups and the comparison group (Ahrens et al9). *Difference between group A and B, P = 0.003.

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    Figure 3.

    Mean (± SEM) change in Oswestry Disability Index (ODI) baseline to 1 year for all groups and the comparison group (Ahrens et al9). *Difference between group A and B, P = 0.001.

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    Figure 4

    Baseline (BL), 1-year, and long-term follow-up (LTFU) patient-reported outcome measures reported as mean ± SEM. Back visual analog scale (VAS) reported in mm.

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    Figure 5

    Long-term magnetic resonance imaging (MRI) results, mean 11.5 years. T2-weighted midsagittal views.

Tables

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    Table 1

    Inclusion criteria used for patient enrollment at the time of surgery.

    Inclusion Criteria
    • Age 21 to 70 years

    • Degenerative disc disease as evidenced by:

      • History, clinical and radiographic findings

      • Darkened disc on MRI

    • Decreased disc height compared to adjacent disc(s)

    • Positive discography at the affected level

    • One lumbar spine level condition from L2 to S1

    • Minimum disc height of 5.5 mm

    • Intact endplates at the affected disc level

    • Six months of failed nonoperative care

    • Patient is able to complete a 2-year follow-up visitation schedule

    • VAS score ≥5 on a 10-point scale

    • ODI score ≥40 on a 100-point scale

    • MRI, magnetic resonance imaging; ODI, Oswestry Disability Index; VAS, visual analog scale.

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    Table 2

    Patient-reported outome measures for long-term follow-up patients.

    PROMBaseline12 MonthsLTFU
     Mean (SEM)Mean (SEM)Mean Change vs Baseline (SEM) P ValueMean (SEM)Mean Change vs Baseline (SEM) P Value
    ODI55.1 (3.4)18.5 (3.7)−36.6 (19.0)<0.000121.7 (4.5)−33.4 (18.4)<0.0001
    VAS back7.6 (1.4)2.2 (2.1)−5.4 (2.9)<0.00013.6 (2.6)−4.0 (2.8)<0.0001
    ANS1.3(0.9)0.5 (0.6)−0.8 (1.1)0.0020.8 (1.2)−0.5 (1.4)0.07
    • ANS, analgesic score; LTFU, long-term follow-up; ODI, Oswestry Disability Index; PROM, patient-reported outcome measure; VAS, visual analog scale.

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    Table 3

    Baseline demographics for groups A and B.

    CharacteristicGroup A (n = 8)Group B (n = 14) P Value
    Age, y, mean (SD)38.5 (3.2)32.6 (2.1)0.061
    Baseline ODI, mean (SD)57.5 (4.6)54.7 (3.6)0.388
    Baseline VAS back, mean (SD)7.1 (0.4)7.6 (0.4)0.404
    Baseline ANS, mean (SD)1.3 (0.4)1.3 (0.4)0.357
    Sex, M/F, n (%)5 (63%)/3 (38%)1 (7%)/13 (93%)
    Smoker, n (%)1 (12.5%)6 (43%)
    Level treated, n (%)
     L4/54 (50%)9 (64%)
     L5/S14 (50%)5 (36%)
    • ANS, analgesic score; ODI, Oswestry Disability Index; VAS, visual analog scale.

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International Journal of Spine Surgery
Vol. 15, Issue 6
1 Dec 2021
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Long-Term Outcomes Following Lumbar Nucleus Replacement
Jeff D. Golan, Frederic Martens, Jeff Griebel, David C. LoPresti, Michael G. Hess, Michael Ahrens
International Journal of Spine Surgery Dec 2021, 15 (6) 1096-1102; DOI: 10.14444/8196

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Long-Term Outcomes Following Lumbar Nucleus Replacement
Jeff D. Golan, Frederic Martens, Jeff Griebel, David C. LoPresti, Michael G. Hess, Michael Ahrens
International Journal of Spine Surgery Dec 2021, 15 (6) 1096-1102; DOI: 10.14444/8196
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  • discogenic
  • low back pain
  • nucleus replacement
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