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dc.contributor.authorFurunes, Håvarden_US
dc.contributor.authorHellum, Christianen_US
dc.contributor.authorEspeland, Ansgaren_US
dc.contributor.authorBrox, Jens Ivaren_US
dc.contributor.authorSmåstuen, Milada Cen_US
dc.contributor.authorBerg, Lindaen_US
dc.contributor.authorStorheim, Kjerstien_US
dc.date.accessioned2019-06-05T09:25:35Z
dc.date.available2019-06-05T09:25:35Z
dc.date.issued2018-12
dc.PublishedFurunes H, Hellum C, Espeland A, Brox JI, Småstuen MC, Berg L, Storheim K. Adjacent Disc Degeneration After Lumbar Total Disc Replacement or Non-operative Treatment: A Randomized Study With Eight-year Follow-up. Spine. 2018;43(24):1695-1703eng
dc.identifier.issn1528-1159
dc.identifier.issn0362-2436
dc.identifier.urihttps://hdl.handle.net/1956/19872
dc.descriptionUnder embargo until: 15.12.2019en_US
dc.description.abstractStudy Design. A randomized controlled multicenter trial with 8-year follow-up. Objective. The aim of this study was to assess the long-term development of adjacent disc degeneration (ADD) after lumbar total disc replacement (TDR) or nonoperative treatment, and to analyze the association between ADD development and clinical outcome. Summary of Background Data. TDR was introduced as a motion-preserving alternative to spinal fusion, which has been reported to increase the risk of ADD. However, ADD may develop naturally regardless of any surgery, and no randomized study has assessed the long-term development of ADD after TDR versus nonoperative treatment. Methods. The study included 126 of the 173 patients with chronic low back pain (LBP) originally included in a randomized study comparing TDR with multidisciplinary rehabilitation. Magnetic resonance imaging (MRI) of the lumbar spine was performed before treatment and at 8-year follow-up. ADD was categorized as increased or not increased based on an evaluation of Modic changes, disc height reduction, disc contour, herniation size, nucleus pulposus signal, and posterior high intensity zones. We used a χ2 test or a Fisher exact test to compare crude proportions, and multiple linear regressions to analyze the association between increased ADD (yes/no) and change in Oswestry Disability Index (ODI) from pre-treatment to follow-up. Results. ADD increased (for at least one ADD variable) in 23 of 57 patients (40%) treated nonoperatively, and 29 of 69 patients (42%) treated with TDR (P = 0.86). We found no significant associations between ADD increase and the change in ODI. Conclusion. Increased ADD occurred with similar frequency after TDR and after nonoperative treatment, and was not related to the clinical outcome at 8-year follow-up.en_US
dc.language.isoengeng
dc.publisherWolters Kluwereng
dc.subjectadjacent disc degenerationeng
dc.subjectlong-term follow-upeng
dc.subjectlow back paineng
dc.subjectnonoperative treatmenteng
dc.subjecttotal disc replacementeng
dc.titleAdjacent Disc Degeneration After Lumbar Total Disc Replacement or Non-operative Treatment: A Randomized Study With Eight-year Follow-upen_US
dc.typePeer reviewed
dc.typeJournal article
dc.date.updated2019-03-15T14:11:22Z
dc.description.versionacceptedVersionen_US
dc.rights.holderCopyright 2018 Wolters Kluwer Health, Inc. All rights reserved.
dc.identifier.doihttps://doi.org/10.1097/brs.0000000000002712
dc.identifier.cristin1596288
dc.source.journalSpine


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