{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T09:01:05Z","timestamp":1780736465863,"version":"3.54.1"},"reference-count":84,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2017,2]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The use of cervical disc arthroplasty (CDA) in spinal practice is controversial. This may be explained by the lack of studies with a large sample size and long-term outcomes. With this survey the authors aimed to evaluate the opinions of spine surgeons on the use of CDA in the current treatment of cervical disc herniation (CDH).<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A web-based survey was sent to all members of AOSpine International by email using SurveyMonkey on July 18, 2016. A single reminder was sent on August 18, 2016. Questions included geographic location; specialty; associated practice model; number of discectomies performed annually; the use of CDA, anterior cervical discectomy (ACD), and anterior cervical discectomy and fusion (ACDF); and the expectations for clinical outcomes of these procedures.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n A total of 383 questionnaires were analyzed. Almost all practitioners (97.9%) were male, with a mean of 15.0 \u00b1 9.7 years of clinical experience. The majority of responders were orthopedic surgeons (54.6%). 84.3% performed ACDF as the standard technique for CDH. 47.8% of the surgeons occasionally used CDA, whereas 7.3% used CDA as standard approach for CDH. The most common arthroplasty device used was the ProDisc-C. Low evidence for benefits and higher costs were the most important reasons for not offering CDA. The risk of adjacent-level disease was considered smaller for CDA as compared with ACDF. However, ACDF was expected to have the highest effectiveness on arm pain (87.5%), followed by CDA (77.9%), while ACD had the least (12.6%).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n In this survey, CDA was not considered to be the routine procedure to treat CDH. Reported benefits included the reduced risk of adjacent-level disease and preservation of motion of the neck. Lack of enough evidence on its effectiveness as well as higher costs were considered to be disadvantages of CDA. More research should be conducted on the implementation impact of CDA and the cost-effectiveness from society's perspective.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2016.11.focus16338","type":"journal-article","created":{"date-parts":[[2017,2,1]],"date-time":"2017-02-01T03:39:09Z","timestamp":1485920349000},"page":"E8","source":"Crossref","is-referenced-by-count":43,"title":["Current practice of cervical disc arthroplasty: a survey among 383 AOSpine International members"],"prefix":"10.3171","volume":"42","author":[{"given":"Timothy C.","family":"Chin-See-Chong","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Erasmus MC University Medical Center Rotterdam, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pravesh S.","family":"Gadjradj","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Erasmus MC University Medical Center Rotterdam, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Boelen","sequence":"additional","affiliation":[{"name":"Kliniek Lange VoorhouT, Rijswijk, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biswadjiet S.","family":"Harhangi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Erasmus MC University Medical Center Rotterdam, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus16338","series-title":"Med Devices (Auckl)","first-page":"397","article-title":"The Mobi-C cervical disc for one-level and two-level cervical disc replacement: a review of the literature","volume":"7","author":"Alvin","year":"2014"},{"key":"b2-focus16338","series-title":"Global Spine J","first-page":"105","article-title":"Cervical total disc arthroplasty","volume":"2","author":"Basho","year":"2012"},{"key":"b3-focus16338","series-title":"N Engl J Med","first-page":"392","article-title":"Clinical practice. Cervical radiculopathy","volume":"353","author":"Carette","year":"2005"},{"key":"b4-focus16338","series-title":"Spine (Phila Pa 1976)","first-page":"2030","article-title":"Impact of neck and arm pain on overall health status","volume":"28","author":"Daffner","year":"2003"},{"key":"b5-focus16338","series-title":"Spine (Phila Pa 1976)","article-title":"Management of symptomatic cervical disk herniation: a survey among Dutch neurosurgeons","author":"de Rooij","year":"2016"},{"key":"b6-focus16338","series-title":"J Spinal Disord Tech","first-page":"314","article-title":"Biomechanical testing of an artificial cervical joint and an anterior cervical plate","volume":"16","author":"DiAngelo","year":"2003"},{"key":"b7-focus16338","series-title":"Am Fam Physician","first-page":"33","article-title":"Cervical radiculopathy: nonoperative management of neck pain and radicular symptoms","volume":"81","author":"Eubanks","year":"2010"},{"key":"b8-focus16338","series-title":"Acta Chir Scand Suppl","first-page":"154","article-title":"Arthroplasty with intercorporal endoprothesis in herniated disc and in painful disc","volume":"357","author":"Fernstr\u00f6m","year":"1966"},{"key":"b9-focus16338","series-title":"J Spinal Disord","first-page":"500","article-title":"Long-term results after anterior cervical fusion and osteosynthetic stabilization for fractures and\/or dislocations of the cervical spine","volume":"8","author":"Goffin"},{"issue":"6 Suppl","key":"b10-focus16338","series-title":"Spine J","first-page":"190S","article-title":"Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion?","volume":"4","author":"Hilibrand","year":"2004"},{"key":"b11-focus16338","series-title":"PLoS One","first-page":"e0149312","article-title":"Mid- to long-term outcomes of cervical disc arthroplasty versus anterior cervical discectomy and fusion for treatment of symptomatic cervical disc disease: a systematic review and meta-analysis of eight prospective randomized controlled trials","volume":"11","author":"Hu","year":"2016"},{"key":"b12-focus16338","series-title":"BMJ","first-page":"b3883","article-title":"Cervical collar or physiotherapy versus wait and see policy for recent onset cervical radiculopathy: randomised trial","volume":"339","author":"Kuijper","year":"2009"},{"issue":"3","key":"b13-focus16338","series-title":"Neurosurg Focus","first-page":"E1","article-title":"Historical review of cervical arthroplasty","volume":"17","author":"Le","year":"2004"},{"key":"b14-focus16338","series-title":"Spine (Phila Pa 1976)","first-page":"375","article-title":"Accelerated degeneration of the segment adjacent to a lumbar fusion","volume":"13","author":"Lee","year":"1988"},{"key":"b15-focus16338","series-title":"Arch Orthop Trauma Surg","first-page":"155","article-title":"Incidence of adjacent segment degeneration in cervical disc arthroplasty versus anterior cervical decompression and fusion meta-analysis of prospective studies","volume":"135","author":"Luo","year":"2015"},{"issue":"6","key":"b16-focus16338","series-title":"Neurosurg Focus","first-page":"ecp1","article-title":"Complications of cervical spine manipulation therapy: 5-year retrospective study in a single-group practice","volume":"13","author":"Malone","year":"2002"},{"issue":"Suppl 1","key":"b17-focus16338","series-title":"Eur J Orthop Surg Traumatol","first-page":"S87","article-title":"Comparison of the short- and long-term treatment effect of cervical disk replacement and anterior cervical disk fusion: a meta-analysis","volume":"25","author":"Muheremu","year":"2015"},{"key":"b18-focus16338","series-title":"J Neurosurg Spine","first-page":"155","article-title":"The future in the care of the cervical spine: interbody fusion and arthroplasty. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004","volume":"1","author":"Mummaneni","year":"2004"},{"key":"b19-focus16338","series-title":"Spine J","first-page":"275","article-title":"Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease","volume":"9","author":"Murrey","year":"2009"},{"key":"b20-focus16338","series-title":"World Neurosurg","first-page":"436","article-title":"Key preoperative clinical factors predicting outcome in surgically treated patients with metastatic epidural spinal cord compression: results from a survey of 438 AOSpine International members","volume":"93","author":"Nater","year":"2016"},{"key":"b21-focus16338","series-title":"[Treatment of cervical radiculopathy caused by a cervical herniated nucleus pulposus.]","author":"Nederlands Vereniging voor Neurochirurgie","year":"2010"},{"key":"b22-focus16338","series-title":"J Neurosurg Spine","first-page":"546","article-title":"Cost-effectiveness analysis: comparing single-level cervical disc replacement and single-level anterior cervical discectomy and fusion: clinical article","volume":"19","author":"Qureshi","year":"2013"},{"key":"b23-focus16338","series-title":"Spine (Phila Pa 1976)","first-page":"521","article-title":"Costs of cervical disc replacement versus anterior cervical discectomy and fusion for treatment of single-level cervical disc disease: an analysis of the Blue Health Intelligence database for acute and long-term costs and complications","volume":"40","author":"Radcliff","year":"2015"},{"key":"b24-focus16338","series-title":"Brain","first-page":"325","article-title":"Epidemiology of cervical radiculopathy. 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A meta-analysis","volume":"146","author":"Zhong","year":"2016"},{"key":"b42-focus16338","series-title":"Clin Orthop Relat Res","first-page":"1307","article-title":"Reoperation after cervical disc arthroplasty versus anterior cervical discectomy and fusion: a meta-analysis","volume":"474","author":"Zhong","year":"2016"},{"key":"b1-focus16338","series-title":"Med Devices (Auckl)","first-page":"397","article-title":"The Mobi-C cervical disc for one-level and two-level cervical disc replacement: a review of the literature","volume":"7","author":"Alvin","year":"2014"},{"key":"b2-focus16338","series-title":"Global Spine J","first-page":"105","article-title":"Cervical total disc arthroplasty","volume":"2","author":"Basho","year":"2012"},{"key":"b3-focus16338","series-title":"N Engl J Med","first-page":"392","article-title":"Clinical practice. 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Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004","volume":"1","author":"Mummaneni","year":"2004"},{"key":"b19-focus16338","series-title":"Spine J","first-page":"275","article-title":"Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease","volume":"9","author":"Murrey","year":"2009"},{"key":"b20-focus16338","series-title":"World Neurosurg","first-page":"436","article-title":"Key preoperative clinical factors predicting outcome in surgically treated patients with metastatic epidural spinal cord compression: results from a survey of 438 AOSpine International members","volume":"93","author":"Nater","year":"2016"},{"key":"b21-focus16338","series-title":"[Treatment of cervical radiculopathy caused by a cervical herniated nucleus pulposus.]","author":"Nederlands Vereniging voor Neurochirurgie","year":"2010"},{"key":"b22-focus16338","series-title":"J Neurosurg Spine","first-page":"546","article-title":"Cost-effectiveness analysis: comparing single-level cervical disc replacement and single-level anterior cervical discectomy and fusion: clinical article","volume":"19","author":"Qureshi","year":"2013"},{"key":"b23-focus16338","series-title":"Spine (Phila Pa 1976)","first-page":"521","article-title":"Costs of cervical disc replacement versus anterior cervical discectomy and fusion for treatment of single-level cervical disc disease: an analysis of the Blue Health Intelligence database for acute and long-term costs and complications","volume":"40","author":"Radcliff","year":"2015"},{"key":"b24-focus16338","series-title":"Brain","first-page":"325","article-title":"Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990","volume":"117","author":"Radhakrishnan","year":"1994"},{"key":"b25-focus16338","series-title":"Arch Orthop Trauma Surg","first-page":"19","article-title":"Cervical disc arthroplasty versus anterior cervical discectomy and fusion for treatment of symptomatic cervical disc disease: a meta-analysis of randomized controlled trials","volume":"135","author":"Rao","year":"2015"},{"key":"b26-focus16338","series-title":"Eur Spine J","first-page":"1115","article-title":"Mid- to long-term outcomes after cervical disc arthroplasty compared with anterior discectomy and fusion: a systematic review and meta-analysis of randomized controlled trials","volume":"23","author":"Ren","year":"2014"},{"key":"b27-focus16338","series-title":"J Am Acad Orthop Surg","first-page":"486","article-title":"Cervical radiculopathy","volume":"15","author":"Rhee","year":"2007"},{"key":"b28-focus16338","series-title":"Clin Orthop Relat Res","first-page":"658","article-title":"What is the incidence and severity of dysphagia after anterior cervical surgery?","volume":"469","author":"Rihn","year":"2011"},{"key":"b29-focus16338","series-title":"Orthopedics","first-page":"889","article-title":"Results of cervical arthroplasty compared with anterior discectomy and fusion: four-year clinical outcomes in a prospective, randomized controlled trial","volume":"34","author":"Sasso","year":"2011"},{"key":"b30-focus16338","series-title":"J Spinal Disord Tech","first-page":"17","article-title":"Incidence and epidemiology of cervical radiculopathy in the United States military: 2000 to 2009","volume":"25","author":"Schoenfeld","year":"2012"},{"key":"b31-focus16338","series-title":"Spine (Phila Pa 1976)","first-page":"2439","article-title":"Motion compensation associated with single-level cervical fusion: where does the lost motion go?","volume":"31","author":"Schwab","year":"2006"},{"key":"b32-focus16338","series-title":"J Bone Joint Surg Am","first-page":"607","article-title":"The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion","volume":"40-A","author":"Smith","year":"1958"},{"key":"b33-focus16338","series-title":"World Neurosurg","first-page":"623","article-title":"Predictors of outcome in patients with cervical spondylotic myelopathy undergoing surgical treatment: a survey of members from AOSpine International","volume":"81","author":"Tetreault","year":"2014"},{"key":"b34-focus16338","series-title":"Spine (Phila Pa 1976)","first-page":"2253","article-title":"Rate of adjacent segment disease in cervical disc arthroplasty versus single-level fusion: meta-analysis of prospective studies","volume":"38","author":"Verma","year":"2013"},{"issue":"1 Suppl","key":"b35-focus16338","series-title":"J Neurosurg","first-page":"17","article-title":"Influence of an artificial cervical joint compared with fusion on adjacent-level motion in the treatment of degenerative cervical disc disease","volume":"96","author":"Wigfield","year":"2002"},{"key":"b36-focus16338","series-title":"Neurosurgery","first-page":"594","article-title":"The incidence of adjacent segment disease requiring surgery after anterior cervical diskectomy and fusion: estimation using an 11-year comprehensive nationwide database in Taiwan","volume":"70","author":"Wu","year":"2012"},{"key":"b37-focus16338","series-title":"Springerplus","first-page":"1188","article-title":"Cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) in symptomatic cervical degenerative disc diseases (CDDDs): an updated meta-analysis of prospective randomized controlled trials (RCTs)","volume":"5","author":"Xie","year":"2016"},{"key":"b38-focus16338","series-title":"Acta Neurochir (Wien)","first-page":"805","article-title":"Cervical arthroplasty in a patient with Klippel-Feil syndrome","volume":"149","author":"Yi","year":"2007"},{"key":"b39-focus16338","series-title":"Neurology","first-page":"673","article-title":"Significance of symptoms and signs in localization of involved root in cervical disk protrusion","volume":"7","author":"Yoss","year":"1957"},{"key":"b40-focus16338","series-title":"Orthopedics","first-page":"e651","article-title":"Systematic review and meta-analysis of randomized controlled trials: comparison of total disk replacement with anterior cervical decompression and fusion","volume":"34","author":"Yu","year":"2011"},{"key":"b41-focus16338","series-title":"Clin Neurol Neurosurg","first-page":"45","article-title":"Does cervical disc arthroplasty have lower incidence of dysphagia than anterior cervical discectomy and fusion? 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