Clinical Application Study Of PDN Lumbar Artificaial Nucleus

Objective To evaluate short term clinic results of prosthetic disc nucleus (PDN) replacement for the treatment of lumbar disc herniation.Methods Twenty cases of lumbar disc herniation(including one case of recurrent lumbar disc herniation) were treated with PDN from June 2003 to November 2003, including 13 males and 7 females with average age of 40.5 years. Each patient was implanted with a single PDN, 7 cases with PR725, 8 cases with PW725 , and 5 cases with PDN-SOLO-7 respectively. Results After surgery, one patient accepted the revision operation to remove the PDN because of device migration, the others experienced pain relief. The nineteen cases were followed-up for 23～29 moths(mean 26.4 months). Compared with preoperative height of intervertebral disc, it gained increase of 17.2%( P<0.01) and migrations of PDN were no longer found. A intervertebral self-fusion was found in one of the nineteen patients and the complication associated with PDN replacement was not reported in other literatures. The average Oswestry score droped from a preoperative rating of 86.8% to a rating of 6.0%,and the mean Prolo score increased from 2.9 to 8.6. The variations of disc height have no correlation with that of ODI and Prolo Score.Conclusion The PDN device has proven effective in treating backleg pain and increase the heights of intervertebral disc in patients with lumbar disc herniation and its short and result is encouraging. The complication of self-fusion in affected disc space might happen after the operation of PDN replacement. Overemphasizing increase of disc height might not be appropriate. Single PDN is suitable to most Chinese patient. The long term result of PDN implantation need to be studied.