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Patient selection for artificial disc replacement (ADR) is somewhat restrictive. Studies have shown that choosing the right patient can make the difference between success and failure. But studies are also ongoing to find out what factors are really important. Most recently, it was discovered that age might not be as important as was once thought.
And another study was done comparing patients who had a previous back surgery with those who had not. The previous surgeries included discectomy, facetectomy, and laminectomy. Using measures that included pain, function, return to work, and patient satisfaction, there were no differences between the two groups.
There was a slight tendency for patients who had not had any prior spine surgeries for faster healing. But the final results measured at the end of two years showed no difference. Some patients were not satisfied with the results of surgery but it was not based on clinical outcomes.
Although this one study suggested that patients who've had a prior back surgery could still benefit from a single-level ADR, it may be a while before the selection criteria changes. More studies are needed to verify these results. Many of the studies around ADRs remain investigational. That means patients are treated in large hospitals where the research is taking place. These operations are not available everywhere yet.
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