Narrative review of total disk arthroplasty (TDA) as an alternative to spinal fusion for degenerative disk disease, covering the rationale, device designs, FDA status, inclusion/exclusion criteria, early clinical results, and unresolved questions for both lumbar and cervical prostheses as of 2006.
When evaluating a patient for lumbar TDA, confirm absence of all exclusion criteria — facet arthropathy, spondylolisthesis, central stenosis, and obesity are disqualifiers. Because FDA IDE trial data showing equivalence to fusion were generated in a tightly selected population.
The 83% ideal-placement rate even among experts underscores that precise surgical technique, not just device selection, drives outcomes.
Narrative review of total disk arthroplasty (TDA) as an alternative to spinal fusion for degenerative disk disease, covering the rationale, device designs, FDA status, inclusion/exclusion criteria, early clinical results, and unresolved questions for both lumbar and cervical prostheses as of 2006.
When evaluating a patient for lumbar TDA, confirm absence of all exclusion criteria — facet arthropathy, spondylolisthesis, central stenosis, and obesity are disqualifiers. Because FDA IDE trial data showing equivalence to fusion were generated in a tightly selected population.
The 83% ideal-placement rate even among experts underscores that precise surgical technique, not just device selection, drives outcomes.