The current status of lumbar total disc replacement.
Total disc replacement is an exciting technology that may one day replace fusion as the gold standard treatment for DDD, but it is currently an experimental procedure in the United States. Promising short- and mid-term results have been reported for TDR, but longer follow-up and randomized trials comparing TDR to fusion and nonsurgical treatment are needed to fully define the role of TDR in the spine surgeon's armamentarium. Short-term complication rates have been acceptably low, but in the long term the durability of TDR implants and the vertebral endplate will provide challenges. Finally, it is essential that practitioners understand that a limited subset of patients are good candidates for TDR and that indiscriminate application of this technology will result in poor outcomes.
Huang
Russel C
RC
Orthopaedic Spine Surgery, University Hospitals of Cleveland-Case Western Reserve University, 11100 Euclid Avenue, BHC 5128, Cleveland, OH 44106, USA. russelhuang@yahoo.com
Sandhu
Harvinder S
HS
D001696:Biomechanical Phenomena; D006801:Humans; D007403:Intervertebral Disc / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery*; D008159:Lumbar Vertebrae; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000009:adverse effects; D016896:Treatment Outcome