Abstract
BACKGROUND: Lumbar degenerative disc disease (DDD) is a leading cause of chronic low back pain and work-related disability. Total lumbar disc prosthesis offers motion preservation and may reduce adjacent segment degeneration compared to fusion. However, long-term functional and occupational outcomes remain underreported. METHODS: This retrospective cohort study included 130 patients (mean age 37.3±7.9 years; 71.54% male) who underwent total lumbar disc replacement between 2008 and 2020. Patients were assessed preoperatively and at a mean follow-up of 13.88 years using Visual Analog Scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and occupational status. Statistical analyses included ANOVA, regression modeling, and correlation analysis. RESULTS: VAS scores improved significantly (back: 8.6±1.7 to 1.6±2.4; leg: 7.3±2.9 to 1.1±0.9; p<.001). ODI decreased from 46.12±7.3 to 27±9.3. At final follow-up, 73.84% of patients returned to their original job, 13.84% transitioned to alternative roles, and 3.07% were pensioned. Patient satisfaction was high (77.69% rated outcome as 10/10). Complication and reoperation rates were low (3.08% and 12.31%, respectively), with no prosthesis revisions. CONCLUSIONS: Total lumbar disc prosthesis provides durable pain relief, functional improvement, and high rates of occupational reintegration. These findings support its use as a motion-preserving alternative to fusion in appropriately selected patients.