Design concepts in lumbar total disc arthroplasty

Fabio Galbusera, Chiara M. Bellini, Thomas Zweig, Stephen Ferguson, Manuela T. Raimondi, Claudio Lamartina, Marco Brayda-Bruno, Maurizio Fornari

Research output: Contribution to journalArticlepeer-review


The implantation of lumbar disc prostheses based on different design concepts is widely accepted. This paper reviews currently available literature studies on the biomechanics of TDA in the lumbar spine, and is targeted at the evaluation of possible relationships between the aims of TDA and the geometrical, mechanical and material properties of the various available disc prostheses. Both theoretical and experimental studies were analyzed, by a PUBMED search (performed in February 2007, revised in January 2008), focusing on single level TDA. Both semi-constrained and unconstrained lumbar discs seem to be able to restore nearly physiological IAR locations and ROM values. However, both increased and decreased ROM was stated in some papers, unrelated to the clinical outcome. Segmental lordosis alterations after TDA were reported in most cases, for both constrained and unconstrained disc prostheses. An increase in the load through the facet joints was documented, for both semi-constrained and unconstrained artificial discs, but with some contrasting results. Semi-constrained devices may be able to share a greater part of the load, thus protecting the surrounding biological structure from overloading and possible early degeneration, but may be more susceptible to wear. The next level of development will be the biomechanical integration of compression across the motion segment. All these findings need to be supported by long-term clinical outcome studies.

Original languageEnglish
Pages (from-to)1635-1650
Number of pages16
JournalEuropean Spine Journal
Issue number12
Publication statusPublished - Dec 2008


  • Biomechanics
  • Disc arthroplasty
  • Lumbar
  • Motion preservation
  • Spinal alignment

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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