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Related Experiment Video

Updated: Feb 28, 2026

Lateral-PLIF for Lumbar Spinal Arthrodesis: A Detailed Step-By-Step Surgical Technique
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Why Lumbar Artificial Disk Replacements (LADRs) Fail.

Kenneth Pettine1, Robert Ryu, Fernando Techy

  • 1*Rocky Mountain Associates in Orthopedic Medicine †Orthopedic Stem Cell Institute, Johnstown, CO ‡Department of Orthopaedics, The Ohio State University, Columbus, OH.

Clinical Spine Surgery
|June 21, 2017
PubMed
Summary

Artificial disk replacement (ADR) shows a 74% clinical success rate at 2 years, with most outcomes stable after 3 months. Patient selection and implant choice are key to improving ADR success rates.

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Area of Science:

  • Spine surgery outcomes
  • Artificial disc replacement technology
  • Clinical trial analysis

Background:

  • Lumbar artificial disk replacement (ADR) outcomes are typically established by 3 months postoperatively.
  • Understanding failure mechanisms in ADR is crucial for improving patient results.

Purpose of the Study:

  • To investigate the reasons for artificial disk replacement (ADR) failure.
  • To analyze the 2-year clinical outcomes of 91 patients from FDA investigational device exemption (IDE) studies.

Main Methods:

  • Retrospective review of prospectively collected data from 91 patients undergoing one-level ADR (Maverick, Charité, Kineflex) at L4-L5 or L5-S1.
  • Clinical success defined as >50% improvement in Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) or no further surgery.

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  • Failure analysis included implant complications and secondary procedures at the index or adjacent spinal segments.

    • Main Results:

    • Overall clinical failure rate was 26% (24/91 patients) at 2-year follow-up.
    • Specific failure rates: Maverick (28%), Charité (39%), Kineflex (14%).
    • Facet pathology accounted for 50% of failures; implant complications occurred in 5% of all patients.

    Conclusions:

    • 74% of patients achieved clinical success with ADR at 2-year follow-up.
    • Outcomes remained stable from the 3-month postoperative mark for most patients (93%).
    • Patient selection and choice of implant type are critical factors for enhancing ADR clinical success.