Results of the prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of the ProDisc-L total disc replacement versus circumferential fusion for the treatment of 1-level degenerative disc disease

Spine (Phila Pa 1976). 2007 May 15;32(11):1155-62; discussion 1163. doi: 10.1097/BRS.0b013e318054e377.


Study design: A prospective, randomized, multicenter, Food and Drug Administration-regulated Investigational Device Exemption clinical trial.

Objective: To evaluate the safety and effectiveness of the ProDisc-L (Synthes Spine, West Chester, PA) lumbar total disc replacement compared to circumferential spinal fusion for the treatment of discogenic pain at 1 vertebral level between L3 and S1.

Summary of background data: As part of the Investigational Device Exemption clinical trial, favorable single center results of lumbar total disc replacement with the ProDisc-L have been reported previously.

Methods: Two hundred eighty-six (286) patients were treated on protocol. Patients were evaluated before and after surgery, at 6 weeks, 3, 6, 12, 18, and 24 months. Evaluation at each visit included patient self-assessments, physical and neurologic examinations, and radiographic evaluation.

Results: Safety of ProDisc-L implantation was demonstrated with 0% major complications. At 24 months, 91.8% of investigational and 84.5% of control patients reported improvement in the Oswestry Low Back Pain Disability Questionnaire (Oswestry Disability Index [ODI]) from preoperative levels, and 77.2% of investigational and 64.8% of control patients met the > or =15% Oswestry Disability Index improvement criteria. Overall neurologic success in the investigational group was superior to the control group (91.2% investigational and 81.4% control; P = 0.0341). At 6 weeks and 3 months follow-up time points, the ProDisc-L patients recorded SF-36 Health Survey scores significantly higher than the control group (P = 0.018, P = 0.0036, respectively). The visual analog scale pain assessment showed statistically significant improvement from preoperative levels regardless of treatment (P < 0.0001). Visual analog scale patient satisfaction at 24 months showed a statistically significant difference favoring investigational patients over the control group (P = 0.015). Radiographic range of motion was maintained within a normal functional range in 93.7% of investigational patients and averaged 7.7 degrees.

Conclusions: ProDisc-L has been found to be safe and efficacious. In properly chosen patients, ProDisc-L has been shown to be superior to circumferential fusion by multiple clinical criteria.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Arthroplasty, Replacement / adverse effects
  • Arthroplasty, Replacement / instrumentation*
  • Device Approval
  • Disability Evaluation
  • Female
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc / diagnostic imaging
  • Intervertebral Disc / physiopathology
  • Intervertebral Disc / surgery*
  • Low Back Pain / drug therapy
  • Low Back Pain / etiology*
  • Low Back Pain / surgery
  • Lumbar Vertebrae*
  • Male
  • Middle Aged
  • Narcotics / therapeutic use
  • Pain Measurement
  • Patient Satisfaction
  • Prospective Studies
  • Prosthesis Design
  • Radiography
  • Range of Motion, Articular
  • Recovery of Function
  • Spinal Diseases / complications
  • Spinal Diseases / diagnostic imaging
  • Spinal Diseases / physiopathology
  • Spinal Diseases / surgery*
  • Spinal Fusion*
  • Time Factors
  • Treatment Outcome
  • United States
  • United States Food and Drug Administration


  • Narcotics