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ABSTRACT
Introduction: A primary cause of chronic low back pain and disability is lumbar degenerative disc disease (DDD). Surgical treatments are available for DDD including fusion or lumbar total disc replacement (TDR). Lumbar TDR is performed as a motion-preserving alternative to lumbar fusion. There are several marketed lumbar TDR devices including the Aesculap Implant Systems activL Artificial Disc, Charité Artificial Disc and the ProDisc-L Total Disc Replacement.
Areas covered: Considering the various surgical options by which lumbar DDD can be managed, here we evaluate the biologic and biomechanical benefits and concerns of the Aesculap activL Artificial Disc. We review the use of the activL Artificial Disc compared to other lumbar TDRs and an alternative to fusion for skeletally mature patients diagnosed with isolated, symptomatic DDD.
Expert commentary: Short-term follow-up studies suggest that under the right circumstances and precise patient selection, lumbar TDR with the Aesculap activL Artificial Disc is a safe and effective alternative to lumbar fusion. Long-term clinical data will provide information about the potential for adjacent level disease, effects of implant wear, and indications for revision surgery. Future clinical and biomechanical studies, as well as device-specific long-term outcome and comparison studies, will assist surgical decision making.
Declaration of interest
F. Girardi holds royalties from Nuvasive, DePuy, and Orthodevelopment and has a Consulting Agreement with Paradigm Spine, DePuy, Nuvasive. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.