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Can Patients With Previous Spine Surgery Have an Artificial Disc Replacement?

Patients who have an artificial disc replacement (ADR) are selected carefully. They must meet certain criteria to be included. Older age, osteoporosis, and previous spinal surgery may exclude them. In this study, the effect of a previous back surgery is reviewed.

All patients were part of the CHARITÉ Investigational Device Exemption (IDE) study. Two groups were included. One group received the CHARITÉ ADR. The other group had a back fusion with a BAK cage. There was a subgroup within each of those groups of patients who had a previous back surgery. The prior operations included discectomy, laminectomy, or facetectomy.

Comparisons were made between patients who had a previous back surgery and those who had not. Measurements were taken before and after surgery up to two years later. Return to work status was reviewed. Pain levels, function, reoperation rates, and adverse events were also compared.

There were no significant differences between the two groups using these measures of outcome. The authors concluded that patients with the three types of previous surgeries mentioned had the same benefit from a one-level ADR as patients who have an ADR as their first operation.

The authors confirm that careful patient selection is still the key to a successful outcome with ADR. Failures and other problems can be avoided by choosing patients who meet the standard criteria. Patients who have had a previous back surgery do not have to be excluded on the basis of that factor.

References: Fred H. Geisler, MD, PhD, et al. Effect of Previous Surgery on Clinical Outcome Following 1-Level Lumbar Arthroplasty. In Journal of Neurosurgery: Spine. February 2008. Vol. 8. No. 2. Pp. 108-114.

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