Revision of Lumbar Total Disc Arthroplasty and Other Anterior Instrumentation

Revision surgery for anterior lumbar fusion and total disc replacement poses significant challenges for both patients and surgeons. Preoperative, intraoperative, and postoperative factors for success include careful patient selection, surgeon experience, and knowledge of technical pitfalls and implant-related problems. Neurological deficit, vascular compromise, polyethylene failure, and infection are absolute indications for revision lumbar surgery. An experienced vascular surgeon, adequate intravenous access, ureteral stents, and femoral access guides are important operative considerations. Total disc replacement has represented the evolution of treatment for painful degenerative disc disease. Despite substantial advances, failures do occur and careful preoperative and intraoperative planning may minimize the life-threatening risks posed by reoperation.