Failures of Lumbar Disc Replacement

The objective of the current investigation was to review the reported failures of lumbar total disc replacement (TDR) and to categorize the types of failures to assist preoperative planning for revision surgery. We found that the complications associated with lumbar TDR are infrequent and can often be traced to either inappropriate indications or technical errors on the part of the surgeon. Anterior revision approaches can be safely undertaken within 2 weeks of the index procedure; however, after that time, adhesion formation increases the risk of major vascular injury and thus should be reserved for compelling clinical circumstances. Most failures can be managed effectively with posterior instrumented fusion.