In this review, we focus on novel surgical techniques and spinal arthroplasty systems in active development. First, we discuss systems that allow for minimally invasive approaches to the lumbar disc space: (1) lateral approaches, (2) posterior approaches, and (3) oblique approaches. These techniques offer the potential for a minimally invasive lumbar arthroplasty system. Second, we discuss novel facet replacement technology The facet joints, with the intervertebral disc, comprise the three-joint complex of the spinal unit. Facet joint health is thus crucial to proper disc biomechanics and function. Finally, we discuss dynamic neutralization of the lumbar spine with an artificial posterior tension band device. This allows for a certain degree of immobilization without fusion. Minimally invasive surgical approaches, facet arthroplasty, and posterior tension band devices may be the future of motion preservation spinal surgery.
