Lumbar Disk Arthroplasty

Indications

• Lumbar disk arthroplasty (LDA) is indicated as a treatment of chronic, incapacitating low back pain that is diskogenic in origin at the L4-5 or L5-S1 level and not accompanied by neural element compression resulting in claudication or radiculopathy. Diagnosis should be documented with magnetic resonance imaging (MRI), plain lumbar spine x-rays, and positive results of provocative diskography of the pathologic level.

• To be considered for surgery, patients should have failed at least 6 months of conservative nonsurgical therapies and ideally be 18 to 50 years old. Patients who have previously undergone posterior disk interventions, such as diskectomy or nucleolysis, may be candidates for LDA as long as no acute neural compression is present and the remaining facet anatomy is sufficient to prevent distraction of the disk space and provide stability of the segment to be operated.