Total lumbar disc replacement (TLDR), arthroplasty
Definitions
Treatment of degenerative disc disease (DDD) by restoring normal mobility of diseased segments and decreasing risk of adjacent-level disc degeneration
Removal of diseased disc and insertion of disc prosthesis
Main goals: Restoration and maintenance of normal or near-normal disc space motion during flexion and extension, right and left lateral bending, and axial rotation
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Othman YA et al: Artificial disc replacement in spine surgery. Ann Transl Med. 7(Suppl 5):S170, 2019
Cui XD et al: Mid- to long-term results of total disc replacement for lumbar degenerative disc disease: a systematic review. J Orthop Surg Res. 13(1):326, 2018
Formica M et al: Lumbar total disc arthroplasty: outdated surgery or here to stay procedure? A systematic review of current literature. J Orthop Traumatol. 18(3):197-215, 2017
Janssen M et al: Challenges and solutions for lumbar total disc replacement implantation. Spine (Phila Pa 1976). 42 Suppl 24:S108-11, 2017
Nunley PD et al: Factors affecting the incidence of symptomatic adjacent level disease in cervical spine after total disc arthroplasty: 2-4 years follow-up of 3 prospective randomized trials. Spine (Phila Pa 1976). 37(6):445-51, 2012
Uschold TD et al: Cervical and lumbar spinal arthroplasty: clinical review. AJNR Am J Neuroradiol. 33(9):1631-41, 2012
Cepoiu-Martin M et al: Artificial cervical disc arthroplasty: a systematic review. Spine (Phila Pa 1976). 36(25):E1623-33, 2011
Murtagh RD et al: New techniques in lumbar spinal instrumentation: what the radiologist needs to know. Radiology. 260(2):317-30, 2011
Di Silvestre M et al: Two-level total lumbar disc replacement. Eur Spine J. 18 Suppl 1:64-70, 2009
Erkan S et al: Biomechanical comparison of a two-level Maverick disc replacement with a hybrid one-level disc replacement and one-level anterior lumbar interbody fusion. Spine J. 9(10):830-5, 2009
Ingalhalikar AV et al: Effect of lumbar total disc arthroplasty on the segmental motion and intradiscal pressure at the adjacent level: an in vitro biomechanical study: presented at the 2008 Joint Spine Section Meeting Laboratory investigation. J Neurosurg Spine. 11(6):715-23, 2009
Murtagh RD et al: Normal and abnormal imaging findings in lumbar total disk replacement: devices and complications. Radiographics. 29(1):105-18, 2009
Center for Devices and Radiological Health, U.S. Food and Drug Administration. New device approval: CHARITÉ Artificial Disc—P040006. Published October 26, 2004. Updated November 17, 2004. Accessed August 21, 2008
Dmitriev AE et al: Effect of multilevel lumbar disc arthroplasty on the operative- and adjacent-level kinematics and intradiscal pressures: an in vitro human cadaveric assessment. Spine J. 8(6):918-25, 2008
Galbusera F et al: Design concepts in lumbar total disc arthroplasty. Eur Spine J. 17(12):1635-50, 2008
Park CK et al: Degenerative changes of discs and facet joints in lumbar total disc replacement using ProDisc II: minimum two-year follow-up. Spine (Phila Pa 1976). 33(16):1755-61, 2008
Marshman LA et al: The accuracy and validity of "routine" X-rays in estimating lumbar disc arthroplasty placement. Spine (Phila Pa 1976). 32(23):E661-6, 2007
Resnick DK et al: Lumbar disc arthroplasty: a critical review. Clin Neurosurg. 54:83-7, 2007
Shim CS et al: CHARITE versus ProDisc: a comparative study of a minimum 3-year follow-up. Spine (Phila Pa 1976). 32(9):1012-8, 2007
Lemaire JP et al: Clinical and radiological outcomes with the Charité artificial disc: a 10-year minimum follow-up. J Spinal Disord Tech. 2005 Aug;18(4):353-9. Erratum in: J Spinal Disord Tech. 19(1):76, 2006
Gamradt SC et al: Lumbar disc arthroplasty. Spine J. 5(1):95-103, 2005
Neal CJ et al: Magnetic resonance imaging evaluation of adjacent segments after disc arthroplasty. J Neurosurg Spine. 3(5):342-7, 2005
Anderson PA et al: Intervertebral disc arthroplasty. Spine (Phila Pa 1976). 29(23):2779-86, 2004
Errico TJ: Why a mechanical disc? Spine J. 4(6 Suppl):151S-157S, 2004
Geisler FH et al: Neurological complications of lumbar artificial disc replacement and comparison of clinical results with those related to lumbar arthrodesis in the literature: results of a multicenter, prospective, randomized investigational device exemption study of Charité intervertebral disc. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004. J Neurosurg Spine. 1(2):143-54, 2004
Hallab N et al: Biomaterial optimization in total disc arthroplasty. Spine (Phila Pa 1976). 28(20):S139-52, 2003
McAfee PC et al: Cervical disc replacement-porous coated motion prosthesis: a comparative biomechanical analysis showing the key role of the posterior longitudinal ligament. Spine (Phila Pa 1976). 28(20):S176-85, 2003
van Ooij A et al: Complications of artificial disc replacement: a report of 27 patients with the SB Charité disc. J Spinal Disord Tech. 16(4):369-83, 2003
Bertagnoli R et al: Indications for full prosthetic disc arthroplasty: a correlation of clinical outcome against a variety of indications. Eur Spine J. 11 Suppl 2:S131-6, 2002
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Clinical Issues
TERMINOLOGY
Synonyms
Total lumbar disc replacement (TLDR), arthroplasty
Definitions
Treatment of degenerative disc disease (DDD) by restoring normal mobility of diseased segments and decreasing risk of adjacent-level disc degeneration
Removal of diseased disc and insertion of disc prosthesis
Main goals: Restoration and maintenance of normal or near-normal disc space motion during flexion and extension, right and left lateral bending, and axial rotation
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Othman YA et al: Artificial disc replacement in spine surgery. Ann Transl Med. 7(Suppl 5):S170, 2019
Cui XD et al: Mid- to long-term results of total disc replacement for lumbar degenerative disc disease: a systematic review. J Orthop Surg Res. 13(1):326, 2018
Formica M et al: Lumbar total disc arthroplasty: outdated surgery or here to stay procedure? A systematic review of current literature. J Orthop Traumatol. 18(3):197-215, 2017
Janssen M et al: Challenges and solutions for lumbar total disc replacement implantation. Spine (Phila Pa 1976). 42 Suppl 24:S108-11, 2017
Nunley PD et al: Factors affecting the incidence of symptomatic adjacent level disease in cervical spine after total disc arthroplasty: 2-4 years follow-up of 3 prospective randomized trials. Spine (Phila Pa 1976). 37(6):445-51, 2012
Uschold TD et al: Cervical and lumbar spinal arthroplasty: clinical review. AJNR Am J Neuroradiol. 33(9):1631-41, 2012
Cepoiu-Martin M et al: Artificial cervical disc arthroplasty: a systematic review. Spine (Phila Pa 1976). 36(25):E1623-33, 2011
Murtagh RD et al: New techniques in lumbar spinal instrumentation: what the radiologist needs to know. Radiology. 260(2):317-30, 2011
Di Silvestre M et al: Two-level total lumbar disc replacement. Eur Spine J. 18 Suppl 1:64-70, 2009
Erkan S et al: Biomechanical comparison of a two-level Maverick disc replacement with a hybrid one-level disc replacement and one-level anterior lumbar interbody fusion. Spine J. 9(10):830-5, 2009
Ingalhalikar AV et al: Effect of lumbar total disc arthroplasty on the segmental motion and intradiscal pressure at the adjacent level: an in vitro biomechanical study: presented at the 2008 Joint Spine Section Meeting Laboratory investigation. J Neurosurg Spine. 11(6):715-23, 2009
Murtagh RD et al: Normal and abnormal imaging findings in lumbar total disk replacement: devices and complications. Radiographics. 29(1):105-18, 2009
Center for Devices and Radiological Health, U.S. Food and Drug Administration. New device approval: CHARITÉ Artificial Disc—P040006. Published October 26, 2004. Updated November 17, 2004. Accessed August 21, 2008
Dmitriev AE et al: Effect of multilevel lumbar disc arthroplasty on the operative- and adjacent-level kinematics and intradiscal pressures: an in vitro human cadaveric assessment. Spine J. 8(6):918-25, 2008
Galbusera F et al: Design concepts in lumbar total disc arthroplasty. Eur Spine J. 17(12):1635-50, 2008
Park CK et al: Degenerative changes of discs and facet joints in lumbar total disc replacement using ProDisc II: minimum two-year follow-up. Spine (Phila Pa 1976). 33(16):1755-61, 2008
Marshman LA et al: The accuracy and validity of "routine" X-rays in estimating lumbar disc arthroplasty placement. Spine (Phila Pa 1976). 32(23):E661-6, 2007
Resnick DK et al: Lumbar disc arthroplasty: a critical review. Clin Neurosurg. 54:83-7, 2007
Shim CS et al: CHARITE versus ProDisc: a comparative study of a minimum 3-year follow-up. Spine (Phila Pa 1976). 32(9):1012-8, 2007
Lemaire JP et al: Clinical and radiological outcomes with the Charité artificial disc: a 10-year minimum follow-up. J Spinal Disord Tech. 2005 Aug;18(4):353-9. Erratum in: J Spinal Disord Tech. 19(1):76, 2006
Gamradt SC et al: Lumbar disc arthroplasty. Spine J. 5(1):95-103, 2005
Neal CJ et al: Magnetic resonance imaging evaluation of adjacent segments after disc arthroplasty. J Neurosurg Spine. 3(5):342-7, 2005
Anderson PA et al: Intervertebral disc arthroplasty. Spine (Phila Pa 1976). 29(23):2779-86, 2004
Errico TJ: Why a mechanical disc? Spine J. 4(6 Suppl):151S-157S, 2004
Geisler FH et al: Neurological complications of lumbar artificial disc replacement and comparison of clinical results with those related to lumbar arthrodesis in the literature: results of a multicenter, prospective, randomized investigational device exemption study of Charité intervertebral disc. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004. J Neurosurg Spine. 1(2):143-54, 2004
Hallab N et al: Biomaterial optimization in total disc arthroplasty. Spine (Phila Pa 1976). 28(20):S139-52, 2003
McAfee PC et al: Cervical disc replacement-porous coated motion prosthesis: a comparative biomechanical analysis showing the key role of the posterior longitudinal ligament. Spine (Phila Pa 1976). 28(20):S176-85, 2003
van Ooij A et al: Complications of artificial disc replacement: a report of 27 patients with the SB Charité disc. J Spinal Disord Tech. 16(4):369-83, 2003
Bertagnoli R et al: Indications for full prosthetic disc arthroplasty: a correlation of clinical outcome against a variety of indications. Eur Spine J. 11 Suppl 2:S131-6, 2002
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