A 7-year minimum follow-up of the M6-L total disk replacement for low back pain with radiculopathy in young railway employees: a retrospective single-center study

Byvaltsev V. Kalinin A. Pestryakov Y. Aliyev M. Yuldashev R. Shcherbatykh A. Riew K.D.
2026 Springer Science and Business Media Deutschland GmbH

European Spine Journal
2026

Purpose: To report our minimum 7-year clinical and radiographic outcomes, as well as complications of the M6-L disk prostheses in railway workers with lumbar disk herniation (LDH) causing low back pain with radiculopathy. Methods: 97 cases underwent total disk replacement (TDR) using the M6-L disk prostheses between 2012 and 2017. Of those, 88.6% had surpassed the minimum 7-year follow-up and were included in the retrospective single-center study. Clinical and radiological data were obtained preoperatively, at 1-year and 106 (90;139) months post-operatively. Factors associated with delayed or failure return to work were identified. Results: 90.7% had a successful outcome, as defined by the FDA. The average range of motion (ROM) of the operated, upper and lower adjacent segments increased significantly at the final follow-up. Intra-operatively, a vena cava tear occurred in 3 patients. Four cases of retrograde ejaculation were observed. At the last follow-up, 3 patients complained of low back pain (VAS > 50 mm), leg pain (VAS > 20 mm) and the ODI > 20 points. There were no cases that required revision surgery due to implant failure. No patient had symptomatic adjacent segment degeneration requiring reoperation. Heterotopic ossification was detected in 35/86 (40.7%) operative segments. At the last follow-up period, 87.2% patients went back to their original work, and 9.3% patients changed jobs, with 3.5% patients unable to return to work. Factors associated with delayed or failure return to work were: age over 40 years, body mass index over 30 kg/m², presence of concomitant pathology, ASA III grade, daily use of painkillers, preoperative heavy-very heavy workload, preoperative segmental ROM at index level 4° and less, less than 15-point improvement in ODI. Conclusions: This study suggests that lumbar TDR using M6-L disk prostheses is a safe and effective treatment for low back pain with radiculopathy caused by LDH at a minimum 7 years postoperatively. We found that the prosthesis retained its functionality in the long-term postoperative period and was associated with good clinical and radiological results with a minimal incidence of complications. The study represents the largest cohort of patients to date with long-term M6-L disc prostheses use status.

Degenerative disc disease , Disc survival , Long-term outcomes , Low back pain with radiculopathy , Lumbar disk herniation , Lumbar total disk replacement , M6-L disk prostheses

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Irkutsk State Medical University, Irkutsk, Russian Federation
Irkutsk State Medical Academy of Postgraduate Education, Irkutsk, Russian Federation
railway clinical hospital irkutsk, Railway Clinical Hospital Irkutsk, Russian Federation
Kazakh-Russian Medical University, Almaty, Kazakhstan
Republican Specialized Scientific and Practical Medical Center for Neurosurgery of the Ministry of Health of the Republic of Uzbekistan, Republican Specialized Scientific and Practical Medical Center for Neurosurgery of the Ministry of Health of the Republic of Uzbekistan, Uzbekistan
Cornell University, Ithaca, United States
Columbia University, New York, United States

Irkutsk State Medical University
Irkutsk State Medical Academy of Postgraduate Education
railway clinical hospital irkutsk
Kazakh-Russian Medical University
Republican Specialized Scientific and Practical Medical Center for Neurosurgery of the Ministry of Health of the Republic of Uzbekistan
Cornell University
Columbia University

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