From the Research
Artificial disc replacement is more effective than spinal fusion in terms of improved physical function, reduced pain, and shorter duration of hospitalization for treating non-radicular lower back pain (LBP), as shown in the most recent and highest quality study by Zhang et al. (1). The study, published in 2014, found that artificial total disc replacement (TDR) was more effective in Oswestry Disability Index (ODI) scores, VAS score, and had a shorter duration of hospitalization compared to lumbar fusion. However, there were no significant differences between the two treatment methods regarding operating time, blood loss, complications, reoperation rate, and the proportion of patients who returned to full-time/part-time work. Key points to consider when deciding between artificial disc replacement and spinal fusion for non-radicular LBP include:
- Improved physical function and reduced pain with TDR
- Shorter duration of hospitalization with TDR
- Similar operating time, blood loss, complications, and reoperation rates between TDR and fusion
- Patient factors, surgeon expertise, and patient preferences should be considered when making a decision between the two surgical approaches, as the clinical evidence does not demonstrate significantly superior outcomes with one procedure over the other in terms of morbidity, mortality, and quality of life. It is essential to note that the benefits of motion preservation and long-term complications are still unclear and require further research, as highlighted by Zhang et al. (1) and other studies, such as Chou et al. (2) and Li et al. (3).