Implant Migration and Dislocation Following Lumbar Total Disc Replacement: A Scoping Review of Risk Factors, Treatment, and Results
5 affiliations
- 1Department of Orthopaedics Surgery, National University Health System, Singapore, Singapore
- 2Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- 3Department of Orthopaedics Surgery, Changi General Hospital, Singapore, Singapore
- 4Department of Orthopaedic Surgery, SportsIn Orthopaedic Clinic, Singapore, Singapore
- 5Department of Orthopaedic Surgery, Centre for Spine and Orthopaedics, Denver, CA, USA
Abstract
BACKGROUND: Lumbar total disc replacement (TDR) is an alternative to interbody fusion for treating symptomatic degenerative disc disease. This approach involves replacing deteriorated lumbar discs with a prosthetic device to alleviate pain and maintain spinal mobility. This review maps the current findings on migration or dislocation related to TDR, identifies contributing factors, and summarizes reported treatment approaches and their results. METHODS: A systematic search was conducted across MEDLINE, Embase, Scopus, Web of Science, and CENTRAL to identify relevant studies. The search identified 7 pertinent studies. The extracted data included study design, patient demographics, type of prosthesis used, direction of migration or dislocation, risk factors, and treatment methods. RESULTS: The review of 7 articles on TDR indicated that significant migration or dislocation requiring surgical intervention was reported in approximately 1% to 2% of cases, typically within weeks to months after the procedure. A higher occurrence of clinically relevant subsidence was reported, which correlated with poorer patient outcomes. Anterior migrations predominated, while posterior and lateral migrations were rare. Risk factors observed included selecting an undersized or improperly positioned implant, surgical technique, and trauma. Treatment strategies ranged from conservative monitoring to revision arthroplasty for early malposition when the endplates were still intact and conversion to fusion. CONCLUSIONS: Clinically significant implant migration following lumbar TDR is rare but remains an important complication. Reported events most commonly occur early after surgery and are associated with heterogeneous factors, including implant sizing, surgical technique, and trauma. Management strategies vary, with conversion to fusion most frequently reported. The current literature remains limited by heterogeneous and inconsistently reported outcomes, highlighting the need for more standardized reporting of migration characteristics, risk factors, management strategies, and clinical outcomes in future studies. CLINICAL RELEVANCE: Mapping the currently reported patterns, risk factors, and management strategies associated with implant migration following lumbar TDR may help inform surgical technique, postoperative surveillance, and future research reporting standards. LEVEL OF EVIDENCE: Not applicable; scoping review.
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BibTeX
@article{gera2026implant,
title = {{Implant Migration and Dislocation Following Lumbar Total Disc Replacement: A Scoping Review of Risk Factors, Treatment, and Results}},
author = {Sumanth Kumar Gera and Yiming Chen and Gennie Lim and Amirzeb Aurangzeb and Terry Hong Lee Teo and Dinesh Shree Kumar and Michael E. Janssen and Zhihong Chew},
journal = {International Journal of Spine Surgery},
year = {2026},
month = jul,
doi = {10.14444/8927},
url = {https://doi.org/10.14444/8927},
note = {Public domain},
}
RIS
TY - JOUR
TI - Implant Migration and Dislocation Following Lumbar Total Disc Replacement: A Scoping Review of Risk Factors, Treatment, and Results
AU - Sumanth Kumar Gera
AU - Yiming Chen
AU - Gennie Lim
AU - Amirzeb Aurangzeb
AU - Terry Hong Lee Teo
AU - Dinesh Shree Kumar
AU - Michael E. Janssen
AU - Zhihong Chew
PY - 2026
DA - 2026/07/29
JO - International Journal of Spine Surgery
DO - 10.14444/8927
UR - https://doi.org/10.14444/8927
AB - BACKGROUND: Lumbar total disc replacement (TDR) is an alternative to interbody fusion for treating symptomatic degenerative disc disease. This approach involves replacing deteriorated lumbar discs with a prosthetic device to alleviate pain and maintain spinal mobility. This review maps the current findings on migration or dislocation related to TDR, identifies contributing factors, and summarizes reported treatment approaches and their results. METHODS: A systematic search was conducted across MEDLINE, Embase, Scopus, Web of Science, and CENTRAL to identify relevant studies. The search identified 7 pertinent studies. The extracted data included study design, patient demographics, type of prosthesis used, direction of migration or dislocation, risk factors, and treatment methods. RESULTS: The review of 7 articles on TDR indicated that significant migration or dislocation requiring surgical intervention was reported in approximately 1% to 2% of cases, typically within weeks to months after the procedure. A higher occurrence of clinically relevant subsidence was reported, which correlated with poorer patient outcomes. Anterior migrations predominated, while posterior and lateral migrations were rare. Risk factors observed included selecting an undersized or improperly positioned implant, surgical technique, and trauma. Treatment strategies ranged from conservative monitoring to revision arthroplasty for early malposition when the endplates were still intact and conversion to fusion. CONCLUSIONS: Clinically significant implant migration following lumbar TDR is rare but remains an important complication. Reported events most commonly occur early after surgery and are associated with heterogeneous factors, including implant sizing, surgical technique, and trauma. Management strategies vary, with conversion to fusion most frequently reported. The current literature remains limited by heterogeneous and inconsistently reported outcomes, highlighting the need for more standardized reporting of migration characteristics, risk factors, management strategies, and clinical outcomes in future studies. CLINICAL RELEVANCE: Mapping the currently reported patterns, risk factors, and management strategies associated with implant migration following lumbar TDR may help inform surgical technique, postoperative surveillance, and future research reporting standards. LEVEL OF EVIDENCE: Not applicable; scoping review.
SN - 2211-4599
ER -