A curious researcher from Croatia has dug into 80 studies to uncover some of the reasons spine and neuro surgeons are occasionally reluctant to perform a total disc replacement (TDR). The study, “Failure of lumbar disc surgery: management by fusion or arthroplasty?” appears in the November 13, 2018 edition of International Orthopaedics.
Arithera Hospital for Special Diseases in Zagreb and author of the study, explained his research to OTW, “I am a spine surgeon, and besides other pathologies I perform disc arthroplasties. I am satisfied with my results. However, there are a lot of controversies in this procedure, and numerous colleagues are against this procedure. My personal interest was to find out what is objective in these pro- and con- arguments.”
with anterior surgery, reimbursement policy, and potential problems with salvage surgery are major reasons for the decline in TDRs.
commented to OTW, “For me the most important information was that we avoid objectively better surgery, because of subjective reasons (for example insufficient competence in anterior surgery).”
“Nobody thinks about turning back to hip fusions, because there are complications and problems in hip arthroplasty. So hip arthroplasty is improving on and on. For me, spine fusions have reached the top of further improvement (there are no further significant improvements possible).”
“Disc arthroplasty is still at the beginning. It is a demanding surgery, but I am convinced that a lot of surgical and constructional improvements can be done. I believe there is no way to go backwards. Despite that it can be difficult, it seems to me that the only way is to solve the problems and move forward.”
Interesting… I know very well who is dr. Kovac from Croatia and what he is doing.
He is NOT doing TDR surgery on routine basis. His reputation in Croatia is well known and most of his TDR procedures were actually converted to ALIF’s by other surgeons.
Beware who are you trusting and what are you reading.
RYORTHO – try to be more serious.
Since you are directly contradicting Dr. Kovac, you need to identify who you are. Dr. Kovac’s signed his name to his opinions. We all sign our names to what we write.
Why do you hide who you are?
You lecture others about trust.
Those are empty words if you don’t disclose who you are and the basis of your criticism.
Robin Young