Artificial Intervertebral Disc Replacement to Provide Dynamic Stability to the Lumbar Spine: A Finite Element Study

Currently, intervertebral disc prostheses that are designed to restore mobility to a vertebral segment are possible for the lumbar spine. The ball-and-socket joint is a constrained design, wherein the rotational axis of the intervertebral joint is forced to pass through the center of the spherical surfaces that form the joint. One advantage of ball-and-socket joints versus unconstrained designs includes better shear stability, which results in sufficient flexibility. In this study, finite element analyses were performed in preimplanted and implanted (intervertebral disc replacement [IDR]) lumbar spine (L1-S) models to examine range of motion (ROM) and the resulting mechanical responses in the implant and the adjacent bones. Four physiological loading conditions including flexion, extension, and left and right lateral bending were analyzed to observe the effect on ROM under a 10-Newton meter moment. In terms of mechanical response, this study shows that disc replacement is an viable alternative to fusion surgery. The added advantage of IDR over fusion for degenerative discs is the reduced chance of disc degeneration at the adjacent segment of spinal vertebral column; with fusion surgery, chances of degeneration are increased.