Degenerative disk disease is one of the major problems of the spine. There is an increasing number of patients having this problem, and the treatment cost is a serious burden to society. Many studies have been conducted to understand the disease better and to find the most appropriate treatment. Conservative treatment is the first step of treatment. However, there are many patients who do not respond to these conservative methods. The fusion procedure is accepted as a gold standard in surgical treatment. On the other hand, there are numerous complications related to the fusion procedure, and the persistence of low back pain despite solid fusion is a great concern. Researchers are working to develop new surgical techniques for this problem. Currently, disc replacement and posterior dynamic stabilization methods are alternatives to the fusion procedures. Both techniques offer satisfactory outcomes and eliminate the risks and complications related to fusion surgery. Total disc replacement (TDR) removes the pain-generating intervertebral disc structure and preserves motion at the applied segment. Preservation of motion might offer better outcomes in regard to adjacent segment problems, which are a major problem following a fusion procedure. On the other hand, the technique has some disadvantages related to the anterior approach. Additionally, malposition of TDR might cause a stress increase at the posterior elements. Posterior dynamic stabilization (PDS) is a relatively new concept. The technique is applied through a posterior approach, which makes it more familiar to spine surgeons. Currently, the dynamism of the construct is obtained either from a dynamic screw or from a dynamic rod. PDS effectively stabilizes the spine while preserving some motion at the applied segment. Thus, it is reasonable to expect fewer complications compared to the fusion method. There are some major differences between TDR and PDS. The TDR is applied through an anterior approach; there is total removal of intervertebral disk material, and the presence of pathology at the posterior elements of the spine is considered a contraindication. However, the PDS technique is applied through a posterior approach; there is no need to perform total disk removal, and the presence of pathology at posterior elements is not considered a contraindication. These factors offer an advantage to PDS compared to TDR. On the other hand, the PDS system is expected to support the spine and allow some motion for life. The materials used in the PDS technique should address these expectations. Today, the major problem with the PDS technique is the material. There are still ongoing research studies to develop material that is strong enough to resist the loads applied to the spine while allowing motion.