Although several artificial disc designs have been developed for the treatment of discogenic low back pain, biomechanical changes with its implantation were rarely studied. To evaluate the effect of artificial disc implantation on the biomechanics of functional spinal unit, a nonlinear three-dimensional finite element model of L4-L5 was developed with 1-mm CT scan data. Biomechanical analysis was performed for two different types of artificial disc having constrained and unconstrained instant center of rotation(ICR), ProDisc and SB Charite III model. The implanted model predictions were compared with that of intact model. Angular motion of vertebral body, forces on the spinal ligaments and facet joint, and stress distribution of vertebral endplate for flexion-extension, lateral bending, and axial rotation with a compressive preload of 400 N were compared. The implanted model showed increased flexion-extension range of motion compared to that of intact model. Under 6Nm moment, the range of motion were 140%, 170% and 200% of intact in SB Charite III model and 133%, 137%, and 138% in ProDisc model. The increased stress distribution on vertebral endplate for implanted cases could be able to explain the heterotopic ossification around vertebral body in clinical observation. As a result of this study, it is obvious that implanted segment with artificial disc suffers from increased motion and stress that can result in accelerated degenerated change of surrounding structure. Unconstrained ICR model showed increased in motion but less stress in the implanted segment than constrained model.
