{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T03:26:37Z","timestamp":1788405997718,"version":"build-2803163510"},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Cervical total disc replacement (TDR) has been shown in a number of prospective clinical studies to be a viable treatment alternative to anterior cervical discectomy and fusion (ACDF) for the treatment of symptomatic degenerative disc disease. In addition to preserving motion, evidence suggests that cervical TDR may result in a lower incidence of subsequent surgical intervention than treatment with fusion. The goal of this study was to evaluate subsequent surgery rates up to 5 years in patients treated with TDR or ACDF at 1 or 2 contiguous levels between C-3 and C-7.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>This was a prospective, multicenter, randomized, unblinded clinical trial. Patients with symptomatic degenerative disc disease were enrolled to receive 1- or 2-level treatment with either TDR as the investigational device or ACDF as the control treatment. There were 260 patients in the 1-level study (179 TDR and 81 ACDF patients) and 339 patients in the 2-level study (234 TDR and 105 ACDF patients).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>At 5 years, the occurrence of subsequent surgical intervention was significantly higher among ACDF patients for 1-level (TDR, 4.5% [8\/179]; ACDF, 17.3% [14\/81]; p = 0.0012) and 2-level (TDR, 7.3% [17\/234]; ACDF, 21.0% [22\/105], p = 0.0007) treatment. The TDR group demonstrated significantly fewer index- and adjacent-level subsequent surgeries in both the 1- and 2-level cohorts.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Five-year results showed treatment with cervical TDR to result in a significantly lower rate of subsequent surgical intervention than treatment with ACDF for both 1 and 2 levels of treatment.<\/jats:p>\n<jats:p>Clinical trial registration no.: NCT00389597 (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"clinicaltrials.gov\" xlink:type=\"simple\">clinicaltrials.gov<\/jats:ext-link>)<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.8.spine15219","type":"journal-article","created":{"date-parts":[[2016,1,22]],"date-time":"2016-01-22T15:52:32Z","timestamp":1453477952000},"page":"734-745","source":"Crossref","is-referenced-by-count":58,"title":["Subsequent surgery rates after cervical total disc replacement using a Mobi-C Cervical Disc Prosthesis versus anterior cervical discectomy and fusion: a prospective randomized clinical trial with 5-year follow-up"],"prefix":"10.3171","volume":"24","author":[{"given":"Robert J.","family":"Jackson","sequence":"first","affiliation":[{"name":"Orange County Neurosurgical Associates, Laguna Hills;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reginald J.","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Greater Baltimore Neurosurgical Associates, Baltimore, Maryland;"}],"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":"Hyun W.","family":"Bae","sequence":"additional","affiliation":[{"name":"Department of Research, Cedars Sinai Spine Center, Los Angeles;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Hisey","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Texas Back Institute, Plano, Texas;"}],"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":"Steven E.","family":"Gaede","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Oklahoma Brain and Spine Institute, Tulsa, Oklahoma; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierce Dalton","family":"Nunley","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Spine Institute of Louisiana, Shreveport, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine15219","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E1593","DOI":"10.1097\/BRS.0b013e31821cfd47","article-title":"Segmental contribution toward total cervical range of motion: a comparison of cervical disc arthroplasty and fusion","volume":"36","author":"Auerbach","year":"2011"},{"key":"b2-spine15219","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1097\/BRS.0000000000000887","article-title":"Comparison of clinical outcomes of 1- and 2-level total disc replacement: four-year results from a prospective, randomized, controlled, multicenter IDE clinical trial","volume":"40","author":"Bae","year":"2015"},{"key":"b3-spine15219","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"841","DOI":"10.1007\/s00586-009-1017-6","article-title":"Intermediate clinical and radiological results of cervical TDR (Mobi-C) with up to 2 years of follow-up","volume":"18","author":"Beaurain","year":"2009"},{"key":"b4-spine15219","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"1298","DOI":"10.2106\/00004623-199309000-00005","article-title":"Robinson anterior cervical discectomy and arthrodesis for cervical radiculopathy. 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