Lumbar total disc replacement patients tended to have more facet injections following surgery compared to those having anterolateral lumbar interbody fusion, according to a study published in the April 2025 issue of the Global Spine Journal.
Researchers used the PearlDiver database to find data for lumbar degenerative disc disease patients who had a single-level, standalone disc replacement or an ALIF/lateral lumbar interbody fusion. The patients were followed for at least two years and excluded if they had a history of facet injections or spinal trauma, fracture, infection or neoplasm.
The groups were matched 1:1 based on age, sex, insurance, year of operation and medical comorbidities.
Each cohort had 1,203 patients. At one year, two years and five years post-surgery, disc replacement patients had significantly higher occurrences of lumbar facet injections than those who had fusions. Five-year injection-free probability curves showed an 87.1% injection-free rate for disc replacement patients and a 92.9% rate for ALIF/LLIF patients.
The study concluded that “compared with ALIF/LLIF, patients who underwent TDR received significantly more facet injections, suggesting a greater progression of symptomatic facet arthrosis. TDR was not protective against reoperations compared to ALIF/LLIF.”
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