Background Lumbar pedicle screw fixation and fusion are major procedures for treating discogenic low back pain (DLBP).However,due to its advantages of preserving the segmental motion and biomechanical simulation,artificial total lumbar disc replacement (TDR) is increasingly popular.Methods From 2007 to 2010,68 DLBP patients were enrolled.TDR were performed on 34 patients and the other 34 controls underwent the traditional fixation procedure.Qualitative and quantitative evaluations were followed including the changes in range of motion (ROM) and interpedicle height (IPH) at the posterior intervertebral body of operated level,in 6 and 12 months,and 3 years,postoperatively.Results Qualitative results showed satisfying improvement in the two groups after 6 and 12 months,respectively,and the inter-group differences were significant (P ＞0.05).The results of ROM and IPH have shown significant differences between the TDR and spinal fusion groups (P ＜0.05).Conclusion With similar clinical improvements as the traditional spinal fusion method,TDR offered significantly better ROM and intervertebral foramen height.