Lumbar Total Disc Replacement
Lumbar total disc replacement (TDR) is a method to treat degenerative disc disease in the lumbar spine in skeletally mature patients without high-grade spondylolisthesis who have failed conservative treatment. Although decompression and fusion for degenerative disc disease is considered the gold standard, potential drawbacks of arthrodesis include pseudarthrosis and adjacent segment disease. The purpose of TDR is to restore and maintain motion segment mobility which is intended to prevent adjacent segment disease and relieve pain. This chapter discusses the background, indications/contraindications, technique including preparation and positioning, approach, and implant placement, along with postoperative care, and outcomes.
KeywordsLumbar total disc replacement Degenerative disc disease Adjacent segment disease Low back pain
- 1.Lumbar total disk arthroplasty Michael F. Duffy and Jack E. Zigler operative techniques: Spine Surgery, PRO. 42:371–7.Google Scholar
- 2.Lumbar total disc arthroplasty Richard D. Guyer and Ernesto Otero-Lopez Benzel’s spine surgery, 184:1591–6.e1.Google Scholar
- 4.Disc Arthroplasty for the Treatment of Degenerative Disorders of the Lumbar Spine David T. Anderson and Adam L. Shimer. Arthritis and Arthroplasty: The Spine, Chapter 47:357–64.Google Scholar
- 8.Failed Total Disc Arthroplasty Andrew K. Simpson and Jack E. Zigler Rothman-Simeone and Herkowitz’s The Spine, Chapter 104:1889–901.Google Scholar
- 13.Blumenthal S, McAfee PC, Guyer RD, et al. A prospective, randomized, multicenter Food and Drug Administration Investigational Device Exemptions study of lumbar total disc replacement with the CHARITE Artificial Disc versus lumbar fusion: part I: evaluation of clinical outcomes. Spine. 2005;30:1565–75.CrossRefGoogle Scholar