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Updated: Aug 5, 2026
05:50
A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations
Published on: August 7, 2018
Expanding indications for lumbar and cervical total disc replacements
Donna D Ohnmeiss1, Richard D Guyer2, Scott L Blumenthal2
1Texas Back Institute Research Foundation, Plano, TX, USA.
Expert Review of Medical Devices
|August 3, 2026
Summary
Total disc replacement (TDR) offers outcomes comparable or better than fusion, with fewer re-operations. Expanding TDR indications responsibly can benefit more patients needing lumbar and cervical spine procedures.
Area of Science:
- Spine surgery
- Orthopedic technology
- Biomechanical engineering
Background:
- Lumbar and cervical total disc replacement (TDR) has a long history.
- Initial FDA trials used narrow patient selection criteria, limiting device applicability.
- Existing literature supports TDR as effective, with outcomes similar or superior to fusion and lower re-operation rates.
Purpose of the Study:
- To review clinical outcomes and indications for lumbar and cervical TDR.
- To explore the expansion of TDR indications beyond initial FDA approvals.
- To provide evidence-based support for the responsible expansion of TDR use.
Main Methods:
- Literature review of lumbar and cervical TDR.
- Searches included PubMed, OVID, and internal electronic libraries.
- Focus on clinical outcomes and indications, including expanded uses.
Main Results:
- TDR demonstrates outcomes comparable or superior to spinal fusion.
- TDR is associated with a lower re-operation rate compared to fusion.
- Expanded indications include hybrid procedures, adjacent segment degeneration, and multi-level TDR.
Conclusions:
- The authors advocate for the responsible expansion of TDR indications.
- Expansion should be guided by literature-based evidence and a focus on patient safety.
- Gradual, stepwise expansion allows for wider application of TDR benefits.
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