BACKGROUND: Artificial lumbar disc replacement is a new choice for the treatment of degenerative disc disease, and preserves lumbar vertebra’s biomechanical characteristics during pain elimination. The design of the prosthesis structure and material needs further study and validation.
OBJECTIVE: To review the structure and material types of presently designed artificial lumbar discs, then to discuss the trends in the optimization design of prosthesis.
METHODS: The PubMed database, China National Knowledge Infrastructure database and Chinese BioMedical Literature Database were searched for related articles concerning artificial lumbar disc and type and biomechanics of nucleus pulposus prosthesis material published from January 2005 to February 2013 by the first author. Key words were “artificial lumbar disc, principle of prosthesis design, structure, material, clinical trials” in Chinese and “artificial lumbar disc, total disc replacement, structure, material, clinical trial” in English. Repetitive and old studies were excluded. 135 articles were found, but 36 articles were included for review.
RESULTS AND CONCLUSION: At present, the materials for intervertebral discs include cobalt-chromium alloy, ceramics, stainless steel, titanium alloy and ultrahigh molecular weight polyethylene. Artificial lumbar disc is commonly made by different materials. Bryan prosthesis is most commonly used in the clinic. Three-dimensional finite element analysis, in vitro trial and clinical studies verified its good biomechanical property. The successful rate of replacement was high. Nucleus prosthesis contains prefabricated type and situ polymerization type, and obtains small injury, so it is a hot focus in present study, but it cannot achieve biomechanical function of human nucleus pulposus. To dig novel material is a future direction for designing individual prosthesis. The prosthetic structure and biomaterial design experience constant improvement and development. This study combines latest study trend and prospects the development of biomimetic design, material improvement, the optimization design of prosthesis and assisted devices.