Formica C, Zanirato A, Divano S, et al. - Via a retrospective review of 30 individuals (n = 32 TDR) underwent total disc arthroplasty (TDR) for low back pain from degenerative disc disease (DDD) resistant to conservative treatment, researchers reported clinical and radiographic results, complications rate and impact on spinal alignment on long-term follow-up (FU), bringing some evidence to ascertain the profile of the most well-suited individuals for TDR. A notable advancement between preoperative and 1-year FU was exhibited by the clinical outcomes measured by the visual analogue scale and Oswestry Disability Index. Between 1-year and long-term FU, no notable temporal variance had been recognized. The surgical revision and the overall rate of complications was 10% and 20%, respectively. In 68.75% of the cases, the mobility of the prosthesis was saved and 73.3% of the individuals were globally well-aligned at the final follow-up. Hence, to achieve great clinical and radiological outcomes, the optimal surgical indication was important. The significance of a coronal deformity < 15° Cobb angle and a Roussouly type 1 or 2 as the profile of the most well-suited patient for TDR was highlighted. The existing evidence relative to the efficiency and safety of TDR as a reliable option in optimal surgery indication, to treat DDD was validated.