Adults suffering from lower back pain often find the cause of pain is degenerative disc disease. While non-surgical treatment is preferred, spinal fusion and total disc replacement remain surgical options for the patient. Total disc replacement is an emerging and improving treatment for degenerative discs. This paper provides a review of lumbar disc replacement for treatment of lower back pain. The mechanics and configuration of the natural disc are first discussed, followed by an introduction of treatment methods that attempt to mimic these mechanics. Total disc replacement types, materials, and failure mechanisms are discussed. Failure mechanisms primarily involve biochemical reactions to implant wear, as well as mechanical incompatibility of the device with natural spine motion. Failure mechanisms include: osteolysis, plastic deformation of polymer components, pitting, fretting, and adjacent level facet and disc degeneration.