Lumbar intervertebral disc replacement in Australia: An epidemiological study

Abstract

Introduction: Favorable short- and long-term outcomes have been reported for lumbar intervertebral total disc replacement (L-TDR). However, there is little evidence regarding the uptake of L-TDR in practice. The objective of this study was to analyze Australian-based population trends in L-TDR over the past 5 years. Methods: The 5-year incidence of L-TDR from 2019 to 2023 in adult patients was analyzed using the Medicare Benefits Schedule (MBS) database. Data were stratified by sex and year, with an offset term introduced using population data from the Australian Bureau of Statistics to account for population changes over the study period. Results: A total of 1558 L-TDRs were completed in Australia under the MBS in the 5 years of interest. The 5-year annual mean case volume was 311.6 cases per annum. A downtrend and plateau in the rate of L-TDR has been seen from 2021 onward. The distribution of L-TDR across ages showed a significantly higher concentration in the 35–44 and 45–54 age groups (P < 0.05). More operations were performed in males (n = 876, 56.2%) than females (n = 682, 43.8%). Conclusions: The uptake of L-TDR has declined throughout the 5-year study period in Australia. Despite modest use currently, the future of L-TDR will rely on more robust long-term outcome data.

Keywords

• degenerative disc disease
• intervertebral disc replacement
• lower back pain
• lumbar spine