Fernando Techy (Johnstown, USA), speaks to BLearning at IMAST 2019 (17–20 July, Amsterdam, The Netherlands) about longer-term trials of disc replacement which, according to Techy, has shown that “we are having less re-operations with disc replacement compared to fusion” and that “disk replacement does protect the adjacent levels in the long run”.
However, the key takeaway, says Techy is that the “vast majority” of these trials are industry sponsored. As such, Techy notes that there is “caution from the spine surgery community” that perhaps the differences between disc replacement and fusion in protecting the adjacent levels is “not as large as these studies have shown”. “We have to be very careful on how we read these studies” and any “potential biases” that could occur, he adds.
Techy believes that both disc replacement and fusion are “excellent” surgeries but that the key to treatment is “patient selection”. Disc replacement is in general indicated in younger patients with fewer levels, no deformity, no instability, no facet disease and less then 50% of disc height loss, he adds.