How effective is total disc replacement (TDR) for chronic low back pain (LBP) in the presence of lumbar disc degeneration?
Although the risk of bias of five studies could be considered low, the most important items, sequence generation, allocation concealment, blinding, and comparable baseline values were not met in most studies. Currently available trials did not assess adjacent level disease and facet joint degeneration adequately.
In the search for better surgical treatment of chronic LBP in the presence of disc degeneration, TDR has received increasing attention in recent years. A possible advantage of TDR compared with fusion is maintained mobility at the operated level, which has been suggested to reduce the chance of adjacent segment degeneration.