ISSN Print: 1050-6934
Volumes:Volume 27, 2017 Volume 26, 2016 Volume 25, 2015 Volume 24, 2014 Volume 23, 2013 Volume 22, 2012 Volume 21, 2011 Volume 20, 2010 Volume 19, 2009 Volume 18, 2008 Volume 17, 2007 Volume 16, 2006 Volume 15, 2005 Volume 14, 2004 Volume 13, 2003 Volume 12, 2002 Volume 11, 2001 Volume 10, 2000
Journal of Long-Term Effects of Medical Implants
Looking Ahead: What Long-Term Outcomes Can We Expect from Spinal Devices for Degenerative Disc Disease
Thomas J. Errico
Division of Spine Surgery, Department of Orthopedics, NYU Hospital for Joint Diseases, New York University School of Medicine, New York, New York
Degenerative disc disease is one of the leading causes of pain and disability. Various surgical treatments are available, but the literature does not provide a comparative overview of their long-term outcomes. This article synthesizes the available long-term evidence on the treatment of degenerative disc disease. Fusion for degenerative disc disease has recently shown good long-term clinical outcomes, yet several studies strongly suggest that it may accelerate the degenerative process at adjacent levels. Arthroplasty shows at least equivalent long-term outcomes and is not expected to accelerate adjacent degeneration, but speculative concern remains about its safety, especially in regard to wear debris and facet joint arthrosis. Many other treatment devices are in various stages of development, but long-term studies are not yet available for most of them. When making treatment decisions, physicians and patients must consider the long-term outcomes, because the devices remain implanted indefinitely, and back pain could recur at any time if the degeneration progresses or the device fails. Before making a treatment decision, surgeons and patients should thoroughly discuss the long-term clinical prognosis, the safety of various procedures, the degrees of certainty in our currently available medical knowledge, and the patient's preferences. No one solution will be right for every patient, but we are entering a golden era of choices, where most patients with degenerative disc disease should be able to find a treatment that substantially improves their condition.
|Begell Digital Portal||Begell Digital Library||eBooks||Journals||References & Proceedings||Research Collections|