Abstract
BACKGROUND CONTEXT: Current lumbar total disc replacement (TDR) devices require an anterior approach for implantation. This approach has inherent limitations, including risks to abdominal structures, and resection of the anterior longitudinal ligament (ALL). Placement of a TDR device from a true lateral (XLIF) approach allows for easier, less invasive access to the disc space. Lateral implantation of TDR also preserves the stabilizing ligaments, which are a natural restraint to excessive rotations and translations, and thereby help to minimize facet stresses. Importantly, implantation from a lateral approach leaves greater opportunity for safer revision surgery, if necessary, by avoiding scarring of anterior vasculature. Additionally, the footprint of the lateral TDR device capitalizes on the biomechanical support of the ring apophysis.
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