{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:16:14Z","timestamp":1787242574926,"version":"build-2736575974"},"reference-count":29,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2015,1]]},"abstract":"\n OBJECT<\/jats:title>\n The purpose of this study was to evaluate the safety and effectiveness of 2-level total disc replacement (TDR) using a Mobi-C cervical artificial disc at 48 months' follow-up.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A prospective randomized, US FDA investigational device exemption pivotal trial of the Mobi-C cervical artificial disc was conducted at 24 centers in the US. Three hundred thirty patients with degenerative disc disease were randomized and treated with cervical total disc replacement (225 patients) or the control treatment, anterior cervical discectomy and fusion (ACDF) (105 patients). Patients were followed up at regular intervals for 4 years after surgery.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n At 48 months, both groups demonstrated improvement in clinical outcome measures and a comparable safety profile. Data were available for 202 TDR patients and 89 ACDF patients in calculation of the primary endpoint. TDR patients had statistically significantly greater improvement than ACDF patients for the following outcome measures compared with baseline: Neck Disability Index scores, 12-Item Short Form Health Survey Physical Component Summary scores, patient satisfaction, and overall success. ACDF patients experienced higher subsequent surgery rates and displayed a higher rate of adjacent-segment degeneration as seen on radiographs. Overall, TDR patients maintained segmental range of motion through 48 months with no device failure.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Four-year results from this study continue to support TDR as a safe, effective, and statistically superior alternative to ACDF for the treatment of degenerative disc disease at 2 contiguous cervical levels.<\/jats:p>\n \n Clinical trial registration no.: NCT00389597 (\n clinicaltrials.gov<\/jats:ext-link>\n )\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2014.7.spine13953","type":"journal-article","created":{"date-parts":[[2014,11,7]],"date-time":"2014-11-07T10:01:56Z","timestamp":1415354516000},"page":"15-25","source":"Crossref","is-referenced-by-count":160,"title":["Two-level total disc replacement with Mobi-C cervical artificial disc versus anterior discectomy and fusion: a prospective, randomized, controlled multicenter clinical trial with 4-year follow-up results"],"prefix":"10.3171","volume":"22","author":[{"given":"Reginald J.","family":"Davis","sequence":"first","affiliation":[{"name":"Greater Baltimore Neurosurgical Associates, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierce Dalton","family":"Nunley","sequence":"additional","affiliation":[{"name":"Spine Institute of Louisiana, Shreveport, Louisiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kee D.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, Davis, Sacramento, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Hisey","sequence":"additional","affiliation":[{"name":"Texas Back Institute, Plano, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Orange County Neurosurgical Associates, Laguna Hills, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun W.","family":"Bae","sequence":"additional","affiliation":[{"name":"Cedars-Sinai Spine Center, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory A.","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Orthopaedics Northeast, Fort Wayne, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven E.","family":"Gaede","sequence":"additional","affiliation":[{"name":"Oklahoma Brain and Spine Institute, Tulsa, Oklahoma; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy O.","family":"Danielson","sequence":"additional","affiliation":[{"name":"Precision Spine Care, Tyler, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Gordon","sequence":"additional","affiliation":[{"name":"Precision Spine Care, Tyler, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus B.","family":"Stone","sequence":"additional","affiliation":[{"name":"Spine Institute of Louisiana, Shreveport, Louisiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"10 Suppl","key":"b1-spine13953","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"S427","DOI":"10.1097\/00007632-199210001-00014","article-title":"Modified Smith-Robinson procedure for anterior cervical discectomy and fusion","volume":"17","author":"Brodke","year":"1992"},{"key":"b2-spine13953","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1097\/00007632-198803000-00003","article-title":"Cervical stabilization by plate and bone fusion","volume":"13","author":"Brown","year":"1988"},{"issue":"Suppl 4","key":"b3-spine13953","series-title":"Rheumatology (Oxford)","doi-asserted-by":"publisher","first-page":"iv42","DOI":"10.1093\/rheumatology\/kei051","article-title":"An introduction to the Atlas of Standard Radiographs of Arthritis","volume":"44","author":"Croft","year":"2005"},{"key":"b4-spine13953","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"943","DOI":"10.3171\/jns.1998.88.6.0943","article-title":"Surgical experience with an implanted artificial cervical joint","volume":"88","author":"Cummins","year":"1998"},{"key":"b5-spine13953","series-title":"J Neurosurg Spine","first-page":"532","article-title":"Cervical total disc replacement with the Mobi-C cervical artificial disc compared with anterior discectomy and fusion for treatment of 2-level symptomatic degenerative disc disease: a prospective, randomized, controlled multi-center clinical trial. 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