Trial reportSpine2018
Progression of Adjacent-level Degeneration After Lumbar Total Disc Replacement: Results of a Post-hoc Analysis of Patients With Available Radiographs From a Prospective Study With 5-year Follow-up.
Trial report in Spine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 24 citations in OpenAlex.
- [Long-Term Functional and Radiological Outcomes of Maverick].Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca · 2026Observational
- Preconditioning Mesenchymal Stem Cells to Enhance Performance in the Degenerate Nucleus Pulposus.Tissue engineering. Part B, Reviews · 2026Review
- Long-Term Range of Motion and Influence on Clinical Outcomes After Lumbar Disc Replacement: A Systematic Review.Global spine journal · 2026Review
- A Comprehensive Review of Spinal Arthroplasty.Neurospine · 2026Review
- Clinical Outcomes After 1 and 2-Level Lumbar Total Disc Arthroplasty: 1,187 Patients with 7 to 21-Year Follow-up.The Journal of bone and joint surgery. American volume · 2025Article
- Single-Level Total Disc Replacement: Index-Level and Adjacent-Level Revision Surgery Incidence, Characteristics, and Outcomes.International journal of spine surgery · 2022Article
- Single and Multilevel Lumbar Total Disc Replacement Adjacent to L5-S1 ALIF (Lumbar Hybrid): 6 Years of Follow-up.International journal of spine surgery · 2021Article
- Long-Term Residual-Mobility and Adjacent Segment Disease After Total Lumbar Disc Replacement.Global spine journal · 2021Article
- Comparative Analysis of 30-Day Readmission, Reoperation, and Morbidity Between Lumbar Disc Arthroplasty Performed in the Inpatient and Outpatient Settings Utilizing the ACS-NSQIP Dataset.Global spine journal · 2021Article
- Use of the sagittal Cobb* angle to guide the rod bending in the treatment of thoracolumbar fractures: a retrospective clinical study.Journal of orthopaedic surgery and research · 2020Article
- Artificial disc replacement in spine surgery.Annals of translational medicine · 2019Review
- Preserving spinal motion: lumbar disc arthroplasty in the US.Current orthopaedic practiceReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designPost-hoc analysis of 5-year follow-up data from a randomized, multicenter trial.
objectiveThe aim of this study was to investigate the incidence of progression in radiographic adjacent-level degeneration (ΔALD) from preoperative assessment to 5 years after total disc replacement (TDR) and the relationship of these changes with range of motion and clinical adjacent-level disease. A secondary objective was to compare adjacent-level degeneration (ALD) outcomes between TDR and fusion. SUMMARY OF BACKGROUND DATA: Fusion is associated with high rates of ALD in symptomatic lumbar disc degeneration. TDR may reduce this risk.
methodsIn total, 175 patients with single-level, symptomatic, lumbar disc degeneration who had received activL or ProDisc-L and had a preoperative and 5-year postoperative radiograph available were included. Over 5-year follow-up, ΔALD was defined as an increase in ALD of ≥1 grade and clinical ALD was defined as surgical treatment at the level adjacent to an index TDR. Matching-adjusted indirect comparisons were conducted to compare ALD outcomes after TDR (current trial) with those after fusion (published trial).
resultsAt 5-year follow-up, 9.7% (17/175) of TDR patients had ΔALD at the superior level. In patients with preoperative ALD at the superior level, most (88% [23/26]) showed no radiographic progression over 5 years. The rate of clinical ALD was 2.3% (4/175) and none of these patients had ALD at baseline. For each degree of range of motion gained at the TDR level, there was a consistent decrease in the percentage of patients with ΔALD. After matching and adjustment of baseline characteristics, TDR had a significantly lower likelihood of ΔALD than fusion (odds ratio 0.32; 95% confidence interval 0.13, 0.76).
conclusionThe rates of ΔALD and clinical ALD in this TDR population were similar to those previously reported in the literature for TDR at 5-year follow-up. TDR had a significantly lower rate of ΔALD than fusion. LEVEL OF EVIDENCE: 3.
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