Biomechanics of lumbar disk arthroplasty

Abstract

Conceptually, nucleus replacement offers the promise of a novel technology to add to the spectrum of surgical techniques to treat a variety of degenerative spine pathologies. Specifically, nucleus replacement has the potential to address degenerative pathologies more complex than simple disc herniation but less advanced than severe degenerative disc disease (DDD). Therefore, nucleus replacement may fill a surgical niche between simple discectomy and total disc replacement or spinal fusion. However, the potential success of nucleus replacement must also be tempered by the lack of long-term clinical results. Today, new technologies for spine surgery are judged on the basis of their safety and efficacy as well as cost-effectiveness. Several nucleus replacement devices are entering or completing pilot feasibility studies. Further clinical investigation with well-designed prospective, randomized pivotal trials is needed to ultimately determine the ideal indications and efficacy of nucleus replacement in the treatment of lumbar DDD.