Skip to the content 
Lumbar Total Disk Replacement Device Removals and Revisions Performed During a 20-Year Experience with 2141 Patients
Study Design
This was a retrospective study with prospective patient contact attempted to collect current data.
Objective
The purpose was to investigate the incidence and reasons for lumbar total disk replacement (TDR) removal or revision.
Summary of Background Data
A concern regarding lumbar TDR was safety, particularly the need for device removal or revision. This may be particularly important considering removal/revision requires repeat anterior exposure with an increased risk of vascular injury.
Methods
Data were collected for a series of 2141 lumbar TDR patients, beginning with the first case experience in 2000. The mean follow-up was 78.6 months. For each case of device removal/revision, the reason, duration from index surgery, and procedure performed were recorded.
Results
Of 2141 patients, 27 (1.26%) underwent TDR removal or revision. Device removal was performed in 24 patients (1.12%), while three patients underwent revision (0.14%). Of the 24 removals, 12 were due to migration and/or loosening, three developed problems post-trauma, two developed lymphocytic reaction to device materials, two had ongoing pain, and there was one case of each: TDR was too large, vertebral body fracture (osteoporosis), lytic lesion, device subsidence and facet arthrosis, and infection seeded from a chest infection 146 months post-TDR. The three revisions were for Core repositioning (technique error), device repositioning after displacement, and core replacement due to wear/failure. With respect to timing, 37.0% of removals/revisions occurred within one-month postimplantation. Of note, 40.7% of removals/revisions occurred in the first 25 TDR cases performed by individual surgeons. There was one significant vascular complication occurring in a patient whose TDR was removed due to trauma. This was also the only patient among 258 with ≥15-year follow-up who underwent removal/revision.
Conclusion
In this large consecutive series, 1.26% of TDRs were removed/revised. The low rate over a 20 year period supports the safety of these devices.
More News & Insights from Cuéllar Spine
Multi-Level Total Disc Replacement: What Patients Should Know
For patients with chronic neck or back pain caused by damaged spinal discs, total disc replacement can be an appealing alternative to s
Dr. Jason M. Cuéllar Leads Opening of DISC Surgery Center at Palm Beach
DISC Surgery Center at Palm Beach is now open, bringing together a distinguished team of spine and orthopedic specialists in a state-of
Dr. Jason M. Cuéllar Performs Inaugural Surgery at DISC Surgery Center at Palm Beach
Jason M. Cuéllar, M.D., Ph.D., performed the inaugural surgical procedure at the newly opened DISC Surgery Center at Palm Beach on Thu
Do I Need to Wear a Brace After Spine Surgery?
One of the most common questions patients ask before spine surgery is: “Will I have to wear a brace afterward?”
Cervical Disc Replacement May Help Patients Return to Work Faster Than Fusion Surgery
A recent meta-analysis comparing cervical disc replacement (CDR) and anterior cervical discectomy and fusion (ACDF) found that patients
Leg Length Discrepancy as a Source of Scoliosis and Back Pain
The human body is built on balance and symmetry. When that balance is disrupted by even a fraction of an inch, the effects can ripple t
When Your Shoulder Pain Is Really Coming from Your Neck
Most people assume shoulder pain must be coming from the shoulder. But that is not always the case. Sometimes, the real source is the n
5 Common Post-Op Symptoms After Lumbar Disc Replacement
Undergoing a lumbar artificial disc replacement (ADR) is a major step toward reclaiming an active lifestyle. Unlike a spinal fusion, AD
Tests Needed Before Lumbar ADR & Cervical ADR
If you are exploring cervical or lumbar artificial disc replacement (ADR), one of the first surprises is how detailed the evaluation ca
