Journal Reports

The Spine Journal 13 (2013) 475–477

The Spine Journal editors present abstracts from selected articles which may be of interest to TSJ readers.

Clinical outcome of lumbar total disc replacement using ProDisc-L

in degenerative disc disease: minimum 5-year follow-up results at

a single institute. Park CK, Ryu KS, Lee KY, Lee HJ. Spine (Phila Pa

1976) 2012;37(8):672–7.

STUDY DESIGN: A retrospective clinical data analysis.

OBJECTIVE: To determine the therapeutic effectiveness of lumbar total

disc replacement (TDR) using ProDisc-L (Synthes Spine, West Chester,

PA) in the patients with degenerative disc diseases (DDD) with a minimum

follow-up of 5 years.

SUMMARY OF BACKGROUND DATA: Early successful clinical re-

sults of lumbar TDR have been reported. However, few reports have pub-

lished its therapeutic effectiveness in the long term.

METHODS: The patients were examined preoperatively and at 3 months, 1

year, 2 years, and more than 5 years postoperatively, and assessed using vi-

sual analog scale (VAS), Oswestry disability index (ODI), physical health

component summary (PCS) of the 36-Item Short Form Health Survey ques-

tionnaire, and sporting activity scale scores. At last follow-up visits, two ad-

ditional questions were asked: satisfaction with surgery and willingness to

undergo the same treatment. Finally, clinical success was assessed using

the Food and Drug Administration definition.

RESULTS: Thirty-five patientswere included in the study. Themean follow-

up period was 72 months (6 years). Postoperatively, all outcome measure

scores (VAS, mean ODI, PCS, and sports activity scores) immediately im-

proved and these improvements were maintained at last follow-up visits with

statistical significance. However, outcome score improvementswere observed

to be slightly, though significantly, lower at last follow-up visits than at 1 or 2

years postoperatively. Eighty-eight percent of patients were "satisfied" or

"somewhat satisfied" with treatment and 60% were prepared to undergo the

same treatment again. Twenty-five patients (71.4%) achieved clinical success.

CONCLUSION: This study reveals that lumbar TDR using ProDisc-L is

a safe and effective treatment for chronic back pain caused by lumbar DDD

as assessed atmore than 5 years postoperatively. Nevertheless, outcome scores

were slightly, though significantly lower at last follow-up visits than at 1 and 2

years postoperatively. A longer-term follow-up study is warranted.

PMID: 21857395 [PubMed - indexed for MEDLINE. Available at: http://

www.ncbi.nlm.nih.gov/pubmed/21857395].

Reprinted with permission from: Park CK, Ryu KS, Lee KY, Lee HJ. Clin-

ical outcome of lumbar total disc replacement using ProDisc-L in degen-

erative disc disease: minimum 5-year follow-up results at a single institute.

Spine (Phila Pa 1976) 2012;37(8):672–7.

http://dx.doi.org/10.1016/j.spinee.2013.02.051

Yoga for chronic low back pain: a randomized trial. Tilbrook HE,

Cox H, Hewitt CE, et al. Ann Intern Med 2011;155(9):569–78.

BACKGROUND: Previous studies indicate that yoga may be an effective

treatment for chronic or recurrent low back pain.

OBJECTIVE: To compare the effectiveness of yoga and usual care for

chronic or recurrent low back pain.

DESIGN: Parallel-group, randomized, controlled trial using computer-

generated randomization conducted from April 2007 to March 2010. Out-

comes were assessed by postal questionnaire. (International Standard

Randomised Controlled Trial Number Register: ISRCTN 81079604)

SETTING: 13non-NationalHealthService premises in theUnitedKingdom.

PATIENTS: 313 adults with chronic or recurrent low back pain.

INTERVENTION: Yoga (n5156) or usual care (n5157). All participants

received a back pain education booklet. The intervention group was

offered a 12-class, gradually progressing yoga program delivered by 12

teachers over 3 months.

MEASUREMENTS: Scores on the Roland-Morris Disability Question-

naire (RMDQ) at 3 (primary outcome), 6, and 12 (secondary outcomes)

months; pain, pain self-efficacy, and general health measures at 3, 6, and

12 months (secondary outcomes).

RESULTS: 93 (60%) patients offered yoga attended at least 3 of the first 6

sessions and at least 3 other sessions. The yoga group had better back function

at 3, 6, and 12 months than the usual care group. The adjusted mean RMDQ

score was 2.17 points (95% CI, 1.03 to 3.31 points) lower in the yoga group

at 3 months, 1.48 points (CI, 0.33 to 2.62 points) lower at 6 months, and

1.57 points (CI, 0.42 to 2.71 points) lower at 12 months. The yoga and usual

care groups had similar back pain and general health scores at 3, 6, and 12

months, and the yoga group had higher pain self-efficacy scores at 3 and 6

months but not at 12 months. Two of the 157 usual care participants and 12

of the 156 yoga participants reported adverse events, mostly increased pain.

LIMITATION: There were missing data for the primary outcome (yoga

group, n521; usual care group, n518) and differential missing data (more

in the yoga group) for secondary outcomes.

CONCLUSION: Offering a 12-week yoga program to adults with chronic

or recurrent low back pain led to greater improvements in back function

than did usual care.

PRIMARY FUNDING SOURCE: Arthritis Research UK.

PMID: 22041945 [PubMed - indexed for MEDLINE. Available at: http://

www.ncbi.nlm.nih.gov/pubmed/22041945].

Reprinted from: Tilbrook HE, Cox H, Hewitt CE, et al. Yoga for chronic

low back pain: a randomized trial. Ann Intern Med 2011;155(9):569–78,

with permission from the American College of Physicians.

http://dx.doi.org/10.1016/j.spinee.2013.02.052

Vitamin D receptor gene and aggrecan gene polymorphisms and the

risk of intervertebral disc degeneration - a meta-analysis. Xu G, Mei

Q, Zhou D, Wu J, Han L. PLoS One 2012;7(11):e50243. Epub 2012

Nov 28.

BACKGROUND: A series of studies have been conducted to evaluate

the associations between vitamin D receptor (VDR) and aggrecan

variable numbers of tandem repeat (VNTR) polymorphisms and the