PEARLS: practical evidence about real life situations.

Bottom LinE Total disc replacement compared with conventional fusion surgery for degenerative disc disease appeared to result in a small but clinically irrelevant improvement with respect to pain relief, disability, and quality of life in a selected population, in the short term (2 years, with only one study extended to 5 years). As harm and complications may occur after years, the spine surgery community should be prudent about adopting this procedure on a large scale.