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This paper focuses on the main areas of spinal arthroplasty including cervical disc replacement, lumbar disc replacement, and lumbar facet arthroplasty. We review the biomechanics, history, outcomes, and future directions for each of these over the last 30 years. Although today spinal arthroplasty is only used in very specific degenerative settings, as innovation in spinal arthroplasty progresses, this will lead to wider adoption and a future where spine surgery is truly reconstructive and motion-preserving.<\/jats:p>","DOI":"10.14245\/ns.2551696.848","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:07:03Z","timestamp":1777421223000},"page":"257-272","update-policy":"https:\/\/doi.org\/10.14245\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Comprehensive Review of Spinal Arthroplasty"],"prefix":"10.14245","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7984-7704","authenticated-orcid":true,"given":"David D","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9741-9275","authenticated-orcid":true,"given":"Evan","family":"Dennis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8481-1432","authenticated-orcid":true,"given":"Advait","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily H.","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1769-5120","authenticated-orcid":true,"given":"Joshua I.","family":"Chalif","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohaid","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4694-6542","authenticated-orcid":true,"given":"John H.","family":"Chi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5355","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-199610000-00001"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199705010-00007"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-011-1783-4"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.nec.2019.08.007"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199512151-00012"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2025.11.030"},{"key":"ref7","first-page":"78S","volume-title":"Lumbar spinal fusion. 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