Background: Authors aim to evaluate the correct placement of TDR using the instant center of rotation (ICR) as a guide.
Methods: Placement of disc would be divided into three groups using a standard of 1 mm from the ICR: Posterior to ICR, In line with ICR and Anterior to ICR.
Results: 49 patients, mean age was 39.96 ± 1.45 years. 42 intraop fluoroscopy images compared to 41 post op radiographic images demonstrated TDR in line with ICR.
Conclusion: Total discs replacements can be placed intraoperatively using proper technique with verification confirmed using the ICR postoperatively.
Keywords: Total disc replacement; instant center of rotation; ideal placement; fluoroscopy; adjacent segment disease; less exposure surgery.