Symptomatic degenerative spinal disease is a serious medical condition that affects many individuals. Modern neuroimaging modalities, the development of new medications, and advances in operative and nonoperative treatments have all contributed to improved outcomes. Unfortunately, there remain a significant number of patients in whom primary therapy either fails or new or recurrent symptoms develop over time. The last decade has witnessed the invention of devices designed to reconstruct the spinal motion segment. These devices can be divided into those that primarily function to replace a nucleus pulposus and those that completely replace the disc complex. In this article the author reviews the background leading to the development of the current group of disc replacements. The design and preliminary clinical results obtained using major lumbar and cervical devices are also reviewed.