Primary Reasons for Removal or Revision

• Device migration or loosening (12 cases)

• Post-traumatic issues (3 cases)

• Lymphocytic reaction to materials (2 cases)

• Ongoing pain despite TDR (2 cases)

• Other rare causes included implant sizing issues, vertebral fractures, infections, or device wear.

Interestingly, 37% of removals/revisions occurred within the first month post-implantation, and nearly 41% occurred within each surgeon’s first 25 cases, highlighting a potential learning curve effect despite TDR’s technical similarity to ALIF approaches.

Long-Term Durability

In patients followed for over 15 years, only one removal/revision occurred, suggesting strong implant durability over the long term. The study also notes that removal/revision rates were significantly higher in females (1.9%) compared to males (0.8%).

Why This Matters

While lumbar disc arthroplasty remains a debated option compared to fusion, this large series adds confidence to the safety and longevity of TDR when performed in appropriately selected patients. Surgeons considering adoption or expanding their disc replacement practice may find these data encouraging, particularly in addressing patient concerns about implant failure and long-term outcomes.

🔬 Stay tuned for the full publication once peer-reviewed and released. We will continue to bring you insights into the data shaping interventional spine care and innovation.