Health-related quality of life in patients undergoing lumbar total disc replacement: A comparison with the general population

- LTDR is a feasible option in selected patients with DDD.
- After LTDR patients have similar HRQOL to the general population at one year after surgery.
- Pain is the dimension in which patients generally have inferior values than norm.
- Previous spinal surgery is a risk factor for decreased HRQOL.

ObjectivesIn up to half of the cases, low back pain (LBP) is thought to be related to a degeneration of the lumbar disc. Lumbar total disc replacement (LTDR) emerged as an alternative to fusion, but its use and indications are still subject to debate. The purpose of this paper was to compare Health-related Quality of life (HRQOL) in patients undergoing LTDR for one or two-level degenerative disc disease (DDD) with the paired age and gender general population values and to assess functional disability and residual pain at one year after the surgical procedure.Material and methodsA series of 51 patients operated on for a one or two level DDD, were evaluated at one year after the surgical procedure. HRQOL was compared to that of paired age and gender general population using the EQ-5D-5L questionnaire. Disability, back (BP) and leg pain (LP) were compared to the preoperative values.ResultsODI showed a mean improvement of 31.78 (p < 0.001, 95% CI 27.39-36.17), BP-VAS of 5.29/10 (95% CI 4.56-6.02), LP-VAS of 4.03/10 (95% CI 3.15-4.92) at one year compared to the preoperative assessment. HRQOL had similar values to the general population in 32 patients and inferior in 19 patients. “Pain” was the HRQOL dimension in which most of the patients had inferior results compared to data from the general population. Patients with previous spinal surgery had lower improvements in HRQOL index, disability, and pain than those without previous surgery.ConclusionsWe found that the majority of patients improved their HQOL to values similar to those of the general population. Disability and pain are significantly reduced compared to preoperative evaluations. Larger scale studies are needed to identify the best candidates for LTDR.