A Comprehensive Review of Spinal Arthroplasty

Spinal arthroplasty aims to preserve or reconstruct the normal biomechanical functions of the spine with motion-preserving implants. Although fusion is a proven technique to stabilize the spine, it is nonphysiologic with known limitations such as loss of mobility and risk of adjacent segment disease. This paper focuses on the main areas of spinal arthroplasty including cervical disc replacement, lumbar disc replacement, and lumbar facet arthroplasty. We review the biomechanics, history, outcomes, and future directions for each of these over the last 30 years. Although today spinal arthroplasty is only used in very specific degenerative settings, as innovation in spinal arthroplasty progresses, this will lead to wider adoption and a future where spine surgery is truly reconstructive and motion-preserving.