To investigate the perioperative complications and their effect on the clinical outcomes after a lumbar total disc replacement (TDR).

Forty-three patients (18 men and 25 women) who had undergone a lumbar TDR from May 2002 and May 2004 were reviewed. Subgroup analysis was performed to determine if age, gender, previous discectomy, multilevel, learning curve of operator, or the difference between preoperative and postoperative disc height were associated with the development of intraoperative or postoperative complications. The patients rated their low back pain on a visual analogue scale and completed an Oswestry disability index (ODI) at the preoperative and postoperative follow-up.

There were 4 cases of intraoperative complications (2 major vein injuries and 2 peritoneal rupture) and 8 cases of postoperative complications (6 radicular pains, 1 subsidence of implant, and 1 dissociation of endplate and polyethylene core). There were no significant differences in the incidence of complications according to age, gender, prior surgery, multilevel, learning curve, or disc height difference (p>0.05). In addition, there were no significant differences in the VAS and ODI between the complication and non-complication groups.

The authors experienced a relatively high rate of complications (11/43 patients) following TDR and statistical analysis did not reveal any associated risk factors.