What it is
The worn disc is removed through an anterior approach and replaced with a mobile implant intended to maintain motion at that level rather than fusing it.
Who it is for
A narrow group: predominantly discogenic back pain at one or two levels, confirmed as the source, in someone with healthy facet joints, good bone quality, normal alignment and no meaningful instability. Most people being considered for a lumbar fusion do not meet these criteria, and the honest conversation usually ends there.
How it works
Through an anterior abdominal approach — generally with an approach surgeon — the great vessels are mobilized and the front of the disc exposed. The disc is removed completely and the endplates prepared. The implant is sized and positioned precisely in the midline under X-ray guidance, since position determines how it moves.
Recovery
Usually one to two nights. Abdominal discomfort and temporary bowel slowing are expected. Walking early; bending and lifting limited for six weeks. Return to desk work commonly two to four weeks.
Risks and alternatives
Vascular injury, which is uncommon but serious; retrograde ejaculation in men; implant settling, migration or wear; persistent pain if the disc was not the true source; and the difficulty of revision noted above. Alternatives are lumbar fusion, non-operative care, or accepting the symptoms.