TDR revision, complication rates low in Swiss government-mandated spine registry

TORONTO — The Swiss government has mandated implementation of a national spine surgery registry that tracks cost and efficacy data for cervical and lumbar total disc arthroplasty and balloon kyphoplasty procedures.

Registry officials have reported positive outcomes for the arthroplasty surgeries analyzed thus far, according to a report at the North American Spine Society 23rd Annual Meeting, here.

After conducting the government-requested Health Technology Assessment (HTA) for one- and two-level total disc replacement (TDR) procedures through 1-year postop, Peter Diel, MD, said, “We had a total revision rate of 2.1% for the follow-up time.” The one-level revision rates were 2.2%, while bi-level surgeries had a revision rate of 2.4%, he added.

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“The conclusions are that the total disc replacement clinically reduces the back and the leg pain, decreases the painkiller consumption and improves the quality of life,” said Diel, of Bern, Switzerland.

In discussing 1-year results for disc replacements tracked in the SWISSspine registry, Diel said registry officials had just received the 2-year results for TDR and balloon kyphoplasty and they were basically unchanged from the previous year.

The SWISSspine registry is a collaborative effort between orthopedic surgeons, academia and industry in Switzerland.

Diel discussed findings for 427 operations involving 497 TDR prostheses, which included 357 one-level and 70 two-level procedures.

For participation in the registry, Swiss spine surgeons completed comorbidity, NASS and European Quality of Life (EQ-5D) forms and others pertaining to the surgical procedure and prostheses used. Patients completed just the EQ-5D form.

Prostheses assessed in the HTA were the Maverick device (Medtronic), the ProDisc-L and ProDisc-C devices (Synthes) and the Charité prosthesis (DePuy, a Johnson & Johnson company), according to Diel.

For more information:

• Peter Diel, MD, can be reached at MEM Research Center for Orthopaedic Surgery, IEFO, University of Bern, Stauffacherstr. 78, CH-3014, Bern, Switzerland; +41-31-6315940; e-mail: peter.diehl@memcenter.unibe.ch. He has no financial conflicts to disclose related to products or companies mentioned in this article.

Reference:

• Diel P, Zweig T, Schluessmann E, et al. SWISSSpine, the first mandatory nationwide HTA registry in Switzerland: Results of lumbar disc arthroplasty. Paper #126. Presented at the North American Spine Society 23rd Annual Meeting. Oct. 15-18, 2008. Toronto.