How Disc Replacement Fits in the Treatment Algorithm for Degenerative Disc Disease: Refining Indications for Disc Replacement

  • Richard D. Guyer
  • Donna D. Ohnmeiss


Today, we have many surgical options for treating symptomatic degenerative disc disease for those patients who fail adequate non-operative treatment. Though many of these technologies are new, they need to pass the test of time with positive objective outcome measures. There has been two decades of experience with TDR in Europe, with good results generally reported, even in studies with more than 10-year follow-up. Randomized trials in the United States have provided a direct comparison to fusion with TDR and found TDR to be as effective as fusion, or more effective on some parameters. In the ideal world where economics was not an issue, the surgeon would have many more options to offer their patients with advancing technology. For the earliest stages of symptomatic disc degeneration, other motion preservation surgeries will suffice, but for the more advanced degeneration, TDR with the ensuing first generation and now second generation will offer our patients more options instead of the traditional fusion. I believe, with newer designs of TDR and in combination with posterior reconstruction, fusion for painful disc degeneration will be restricted to fewer and fewer patients.


Disc Degeneration Disc Space Degenerative Disc Disease Total Disc Replacement Disc Replacement 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  1. 1.Texas Back InstitutePlanoUSA

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