{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:19:29Z","timestamp":1783469969114,"version":"3.55.0"},"reference-count":78,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Cervical disc arthroplasty (CDA) has emerged as a motion-preserving treatment for symptomatic cervical disc disease refractory to nonoperative management in carefully selected patients. Given the interest in expanding on-label uses to include procedures such as hybrid arthroplasty-fusion constructs and 3- and 4-level arthroplasty, authors of this study sought to define the contemporary prevalence of absolute and relative contraindications to cervical arthroplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors conducted a retrospective observational cross-sectional study of all patients in whom &gt; 6 weeks of nonoperative management had failed and who subsequently underwent cervical spine surgery at a single academic institution between January 1, 2022, and September 1, 2024. They reviewed the US Food and Drug Administration investigational device exemption studies of several cervical arthroplasty devices for their listed contraindications. Trauma, infection, malignancy, and deformity cases were excluded from analysis, as were cases with &lt; 3 months of clinical follow-up. For each patient, preoperative cervical spine imaging and clinical data were reviewed and assessed for the presence of each contraindication, type of surgical procedure performed, and proportion of cases that would have been candidates for CDA had each contraindication been relaxed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 334 cases were reviewed. Of these, 268 (80.2%) had at least 1 contraindication to CDA, and 66 (19.8%) were eligible for the procedure. The most common contraindications were severe spondylosis, disc height loss, facet degeneration, &gt; 2 operative levels, and adjacent fusion. Only 24 (36.4%) of the 66 eligible patients underwent CDA, and the remainder underwent posterior foraminotomy (37.9%), anterior cervical discectomy and fusion (21.2%), or laminectomy\/laminoplasty (4.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In this contemporary analysis of an academic practice, 19.8% of operative cervical spine degeneration cases met the criteria for CDA. Further studies suggesting expansions or changes to the indications for CDA must pay careful attention to the patient population being evaluated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.3.focus251101","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:01:06Z","timestamp":1782259266000},"page":"E2","source":"Crossref","is-referenced-by-count":0,"title":["What is the prevalence of contraindications to cervical arthroplasty among operative degenerative spine cases at an academic center?"],"prefix":"10.3171","volume":"61","author":[{"given":"Darius","family":"Ansari","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garret P.","family":"Greeneway","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niall A.","family":"Buckley","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel P.","family":"Brooks","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley T.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory R.","family":"Trost","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel K.","family":"Resnick","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Neurosurg Clin N Am","first-page":"21","article-title":"The natural history of degenerative cervical myelopathy","volume":"29","author":"Badhiwala JH","year":"2018","unstructured":"Badhiwala JH, Wilson JR. The natural history of degenerative cervical myelopathy. Neurosurg Clin N Am. 2018;29(1):21\u201332. doi:10.1016\/j.nec.2017.09.002"},{"issue":"5","key":"b2","series-title":"J Spinal Disord Tech","first-page":"E251","article-title":"Cervical radiculopathy: epidemiology, etiology, diagnosis, and treatment","volume":"28","author":"Woods BI","year":"2015","unstructured":"Woods BI, Hilibrand AS. Cervical radiculopathy: epidemiology, etiology, diagnosis, and treatment. J Spinal Disord Tech. 2015;28(5):E251\u2013E259. doi:10.1097\/BSD.0000000000000284"},{"issue":"3 Suppl","key":"b3","series-title":"Global Spine J.","first-page":"70S","article-title":"A clinical practice guideline for the management of patients with degenerative cervical myelopathy: recommendations for patients with mild, moderate, and severe disease and nonmyelopathic patients with evidence of cord compression","volume":"7","author":"Fehlings MG","year":"2017","unstructured":"Fehlings MG, Tetreault LA, Riew KD,  A clinical practice guideline for the management of patients with degenerative cervical myelopathy: recommendations for patients with mild, moderate, and severe disease and nonmyelopathic patients with evidence of cord compression. Global Spine J. 2017;7(3 Suppl):70S\u201383S.  doi:10.1177\/2192568217701914"},{"issue":"s2","key":"b4","series-title":"Int J Spine Surg","first-page":"S5","article-title":"Cervical disc arthroplasty: rationale and history","volume":"14","author":"Derman PB","year":"2020","unstructured":"Derman PB, Zigler JE. Cervical disc arthroplasty: rationale and history. Int J Spine Surg. 2020;14(s2):S5-S13. doi:10.14444\/7086"},{"issue":"4","key":"b5","series-title":"J Neurosurg Spine","first-page":"516","article-title":"Clinical and radiographic analysis of an artificial cervical disc: 7-year follow-up from the Prestige prospective randomized controlled clinical trial: clinical article","volume":"21","author":"Burkus JK","year":"2014","unstructured":"Burkus JK, Traynelis VC, Haid RW Jr, Mummaneni PV. Clinical and radiographic analysis of an artificial cervical disc: 7-year follow-up from the Prestige prospective randomized controlled clinical trial: clinical article. J Neurosurg Spine. 2014;21(4):516\u2013528. doi:10.3171\/2014.6.SPINE13996"},{"issue":"1","key":"b6","series-title":"J Neurosurg Spine","first-page":"36","article-title":"Prospective randomized study of cervical arthroplasty and anterior cervical discectomy and fusion with long-term follow-up: results in 74 patients from a single site","volume":"18","author":"Coric D","year":"2013","unstructured":"Coric D, Kim PK, Clemente JD, Boltes MO, Nussbaum M, James S. Prospective randomized study of cervical arthroplasty and anterior cervical discectomy and fusion with long-term follow-up: results in 74 patients from a single site. J Neurosurg Spine. 2013;18(1):36\u201342. doi:10.3171\/2012.9.SPINE12555"},{"issue":"1","key":"b7","series-title":"J Neurosurg Spine","first-page":"15","article-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","volume":"22","author":"Davis RJ","year":"2015","unstructured":"Davis RJ, Nunley PD, Kim KD,  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. J Neurosurg Spine. 2015;22(1):15\u201325. doi:10.3171\/2014.7.SPINE13953"},{"issue":"4","key":"b8","series-title":"J Spinal Disord Tech","first-page":"E237","article-title":"Prospective, randomized comparison of cervical total disk replacement versus anterior cervical fusion: results at 48 months follow-up","volume":"28","author":"Hisey MS","year":"2015","unstructured":"Hisey MS, Bae HW, Davis RJ,  Prospective, randomized comparison of cervical total disk replacement versus anterior cervical fusion: results at 48 months follow-up. J Spinal Disord Tech. 2015;28(4):E237\u2013E243. doi:10.1097\/BSD.0000000000000185"},{"issue":"10","key":"b9","series-title":"Spine (Phila Pa 1976)","first-page":"674","article-title":"Long-term outcomes of the US FDA IDE prospective, randomized controlled clinical trial comparing PCM cervical disc arthroplasty with anterior cervical discectomy and fusion","volume":"40","author":"Phillips FM","year":"2015","unstructured":"Phillips FM, Geisler FH, Gilder KM, Reah C, Howell KM, McAfee PC. Long-term outcomes of the US FDA IDE prospective, randomized controlled clinical trial comparing PCM cervical disc arthroplasty with anterior cervical discectomy and fusion. Spine (Phila Pa 1976). 2015;40(10):674\u2013683. doi:10.1097\/BRS.0000000000000869"},{"issue":"18","key":"b10","series-title":"J Bone Joint Surg Am","first-page":"1684","article-title":"Results of cervical arthroplasty compared with anterior discectomy and fusion: four-year clinical outcomes in a prospective, randomized controlled trial","volume":"93","author":"Sasso RC","year":"2011","unstructured":"Sasso RC, Anderson PA, Riew KD, Heller JG. Results of cervical arthroplasty compared with anterior discectomy and fusion: four-year clinical outcomes in a prospective, randomized controlled trial. J Bone Joint Surg Am. 2011;93(18):1684\u20131692. doi:10.2106\/JBJS.J.00476"},{"issue":"12","key":"b11","series-title":"Int Orthop","first-page":"2533","article-title":"A prospective, randomised, controlled multicentre study comparing cervical disc replacement with anterior cervical decompression and fusion","volume":"38","author":"Zhang HX","year":"2014","unstructured":"Zhang HX, Shao YD, Chen Y,  A prospective, randomised, controlled multicentre study comparing cervical disc replacement with anterior cervical decompression and fusion. Int Orthop. 2014;38(12):2533\u20132541. doi:10.1007\/s00264-014-2497-5"},{"issue":"21","key":"b12","series-title":"Food and Drug Administration Investigational Device Exemption Study. J Bone Joint Surg Am","first-page":"1738","article-title":"ProDisc-C total disc replacement versus anterior cervical discectomy and fusion for single-level symptomatic cervical disc disease: seven-year follow-up of the prospective randomized U.S","volume":"97","author":"Janssen ME","year":"2015","unstructured":"Janssen ME, Zigler JE, Spivak JM, Delamarter RB, Darden BV II, Kopjar B. ProDisc-C total disc replacement versus anterior cervical discectomy and fusion for single-level symptomatic cervical disc disease: seven-year follow-up of the prospective randomized U.S. Food and Drug Administration Investigational Device Exemption Study. J Bone Joint Surg Am. 2015;97(21):1738\u20131747. doi:10.2106\/JBJS.N.01186"},{"issue":"7","key":"b13","series-title":"Spine J","first-page":"1026","article-title":"Cervical disc arthroplasty: do conflicts of interest influence the outcome of clinical studies","volume":"17","author":"Narain AS","year":"2017","unstructured":"Narain AS, Hijji FY, Yom KH, Kudaravalli KT, Singh K. Cervical disc arthroplasty: do conflicts of interest influence the outcome of clinical studies? Spine J. 2017;17(7):1026\u20131032. doi:10.1016\/j.spinee.2017.03.018"},{"issue":"6","key":"b14","series-title":"Spine J","first-page":"965","article-title":"The NECK trial: effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; a double-blinded randomized controlled trial","volume":"19","author":"Vleggeert-Lankamp CLA","year":"2019","unstructured":"Vleggeert-Lankamp CLA, Janssen TMH, van Zwet E,  The NECK trial: effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; a double-blinded randomized controlled trial. Spine J. 2019;19(6):965\u2013975. doi:10.1016\/j.spinee.2018.12.013"},{"key":"b15","series-title":"World Neurosurg","first-page":"116","article-title":"Multilevel cervical arthroplasty: expanding indications","volume":"164","author":"Schupper AJ","year":"2022","unstructured":"Schupper AJ, Steinberger J, Gologorsky Y. Multilevel cervical arthroplasty: expanding indications. World Neurosurg. 2022;164:116. doi:10.1016\/j.wneu.2022.04.076"},{"issue":"9","key":"b16","series-title":"Clin Spine Surg","first-page":"375","article-title":"Current and expanded indications for cervical disc arthroplasty: beyond the FDA IDE studies","volume":"36","author":"Divi SN","year":"2023","unstructured":"Divi SN, Plantz MA, Tegethoff J, Su BW. Current and expanded indications for cervical disc arthroplasty: beyond the FDA IDE studies. Clin Spine Surg. 2023;36(9):375\u2013385. doi:10.1097\/BSD.0000000000001525"},{"key":"b17","year":"2019","unstructured":"Summary of safety and effectiveness data (P170036B). M6-C Artificial Cervical Disc. US Food & Drug Administration; 2019.Accessed May 27, 2026.https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf17\/P170036B.pdf"},{"key":"b18","year":"2009","unstructured":"Summary of safety and effectiveness data (P060023C). BRYAN Cervical Disc. US Food & Drug Administration; 2009.Accessed May 27, 2026.https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf6\/p060023c.pdf"},{"key":"b19","year":"2013","unstructured":"Summary of safety and effectiveness data (P110002B). Mobi-C Cervical Disc Prosthesis. US Food & Drug Administration; 2013.Accessed May 27, 2026.https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf11\/p110002b.pdf"},{"key":"b20","year":"2012","unstructured":"Summary of safety and effectiveness data (P100012B). PCM Cervical Disc. US Food & Drug Administration; 2012.Accessed May 27, 2026.https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf10\/p100012b.pdf"},{"key":"b21","year":"2007","unstructured":"Summary of safety and effectiveness data (P070001B). ProDisc-C Total Disc Replacement. US Food & Drug Administration; 2007.Accessed May 27, 2026.https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf10\/p100012b.pdf"},{"key":"b22","year":"2012","unstructured":"Summary of safety and effectiveness data (P100003B). SECURE-C Cervical Artificial Disc. US Food & Drug Administration; 2012.Accessed May 27, 2026.https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf10\/p100003b.pdf"},{"key":"b23","year":"2020","unstructured":"Summary of safety and effectiveness data (P200022B). Simplify Cervical Artificial Disc. US Food & Drug Administration; 2020.Accessed May 27, 2026.https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf20\/P200022B.pdf"},{"key":"b24","year":"2014","unstructured":"Summary of safety and effectiveness data (P090029B). PRESTIGE LP Cervical Disc. US Food & Drug Administration; 2014.Accessed May 27, 2026.https:\/\/www.goohttps:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf9\/p090029b.pdf"},{"issue":"7","key":"b25","series-title":"Clin Spine Surg","first-page":"E283","article-title":"Trends in indications and contraindications for cervical disk arthroplasty from 2009 to 2019","volume":"37","author":"Shafi K","year":"2024","unstructured":"Shafi K, Du JY, Blackburn CW,  Trends in indications and contraindications for cervical disk arthroplasty from 2009 to 2019. Clin Spine Surg. 2024;37(7):E283\u2013E289. doi:10.1097\/BSD.0000000000001589"},{"issue":"3","key":"b26","series-title":"Spine (Phila Pa 1976)","first-page":"249","article-title":"Utilization trends of cervical artificial disc replacement after FDA approval compared with anterior cervical fusion: adoption of new technology","volume":"39","author":"Lu Y","year":"2014","unstructured":"Lu Y, McAnany SJ, Hecht AC, Cho SK, Qureshi SA. Utilization trends of cervical artificial disc replacement after FDA approval compared with anterior cervical fusion: adoption of new technology. Spine (Phila Pa 1976). 2014;39(3):249\u2013255. doi:10.1097\/BRS.0000000000000113"},{"issue":"3","key":"b27","series-title":"Neurosurg Focus","first-page":"E1","article-title":"Historical review of cervical arthroplasty","volume":"17","author":"Le H","year":"2004","unstructured":"Le H, Thongtrangan I, Kim DH. Historical review of cervical arthroplasty. Neurosurg Focus. 2004;17(3):E1. doi:10.3171\/foc.2004.17.3.1"},{"issue":"3","key":"b28","series-title":"J Neurosurg Spine","first-page":"198","article-title":"Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial","volume":"6","author":"Mummaneni PV","year":"2007","unstructured":"Mummaneni PV, Burkus JK, Haid RW, Traynelis VC, Zdeblick TA. Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial. J Neurosurg Spine. 2007;6(3):198\u2013209. doi:10.3171\/spi.2007.6.3.198"},{"issue":"2","key":"b29","series-title":"Spine J","first-page":"210","article-title":"Should patient eligibility criteria for cervical disc arthroplasty (CDA) be expanded? A retrospective cohort analysis of relatively contraindicated patients undergoing CDA","volume":"24","author":"Patel N","year":"2024","unstructured":"Patel N, Abdelmalek G, Coban D,  Should patient eligibility criteria for cervical disc arthroplasty (CDA) be expanded? A retrospective cohort analysis of relatively contraindicated patients undergoing CDA. Spine J. 2024;24(2):210\u2013218. doi:10.1016\/j.spinee.2023.09.017"},{"issue":"s2","key":"b30","series-title":"Int J Spine Surg","first-page":"S29","article-title":"Patient selection in cervical disc arthroplasty","volume":"14","author":"Nunley P","year":"2020","unstructured":"Nunley P, Frank K, Stone M. Patient selection in cervical disc arthroplasty. Int J Spine Surg. 2020;14(s2):S29-S35. doi:10.14444\/7088"},{"issue":"5","key":"b31","series-title":"Spine J","first-page":"711","article-title":"The prevalence of indications and contraindications to cervical total disc replacement","volume":"8","author":"Auerbach JD","year":"2008","unstructured":"Auerbach JD, Jones KJ, Fras CI, Balderston JR, Rushton SA, Chin KR. The prevalence of indications and contraindications to cervical total disc replacement. Spine J. 2008;8(5):711\u2013716. doi:10.1016\/j.spinee.2007.06.018"},{"issue":"11","key":"b32","series-title":"Spine (Phila Pa 1976)","first-page":"978","article-title":"Differences in the surgical treatment of lower back pain among spine surgeons in the United States","volume":"41","author":"Lubelski D","year":"2016","unstructured":"Lubelski D, Williams SK, O\u2019Rourke C,  Differences in the surgical treatment of lower back pain among spine surgeons in the United States. Spine (Phila Pa 1976). 2016;41(11):978\u2013986. doi:10.1097\/BRS.0000000000001396"},{"issue":"12","key":"b33","series-title":"Spine (Phila Pa 1976)","first-page":"1337","article-title":"Superiority of multilevel cervical arthroplasty outcomes versus single-level outcomes: 229 consecutive PCM prostheses","volume":"32","author":"Pimenta L","year":"2007","unstructured":"Pimenta L, McAfee PC, Cappuccino A, Cunningham BW, Diaz R, Coutinho E. Superiority of multilevel cervical arthroplasty outcomes versus single-level outcomes: 229 consecutive PCM prostheses. Spine (Phila Pa 1976). 2007;32(12):1337\u20131344. doi:10.1097\/BRS.0b013e318059af12"},{"key":"b34","series-title":"World Neurosurg","first-page":"e151","article-title":"Is cervical disc replacement valuable in 3-level hybrid surgery compared with 3-level anterior cervical discectomy and fusion","volume":"146","author":"Wang H","year":"2021","unstructured":"Wang H, Huang K, Liu H,  Is cervical disc replacement valuable in 3-level hybrid surgery compared with 3-level anterior cervical discectomy and fusion? World Neurosurg. 2021;146:e151\u2013e160. doi:10.1016\/j.wneu.2020.10.057"},{"issue":"6","key":"b35","series-title":"J Neurosurg Spine","first-page":"653","article-title":"Cervical disc arthroplasty with the Prestige LP disc versus anterior cervical discectomy and fusion, at 2 levels: results of a prospective, multicenter randomized controlled clinical trial at 24 months","volume":"26","author":"Gornet MF","year":"2017","unstructured":"Gornet MF, Lanman TH, Burkus JK,  Cervical disc arthroplasty with the Prestige LP disc versus anterior cervical discectomy and fusion, at 2 levels: results of a prospective, multicenter randomized controlled clinical trial at 24 months. J Neurosurg Spine. 2017;26(6):653\u2013667. doi:10.3171\/2016.10.SPINE16264"},{"issue":"4","key":"b36","series-title":"Int J Spine Surg","first-page":"483","article-title":"Restoration of spinal motion: conversion of anterior cervical fusion with pseudarthrosis to artificial disc replacement","volume":"14","author":"Lanman TH","year":"2020","unstructured":"Lanman TH, Cu\u00c9llar JM. Restoration of spinal motion: conversion of anterior cervical fusion with pseudarthrosis to artificial disc replacement. Int J Spine Surg. 2020;14(4):483\u2013487. doi:10.14444\/7063"},{"key":"b37","series-title":"Clin Neurol Neurosurg","first-page":"59","article-title":"Cervical arthroplasty versus anterior cervical fusion for symptomatic adjacent segment disease after anterior cervical fusion surgery: review of treatment in 41 patients","volume":"162","author":"Lee SB","year":"2017","unstructured":"Lee SB, Cho KS. Cervical arthroplasty versus anterior cervical fusion for symptomatic adjacent segment disease after anterior cervical fusion surgery: review of treatment in 41 patients. Clin Neurol Neurosurg. 2017;162:59\u201366. doi:10.1016\/j.clineuro.2017.08.001"},{"issue":"3","key":"b38","series-title":"J Spinal Disord Tech","first-page":"106","article-title":"Radiographic variables that may predict clinical outcomes in cervical disk replacement surgery","volume":"28","author":"Rihn JA","year":"2015","unstructured":"Rihn JA, Radcliff K, Hipp J,  Radiographic variables that may predict clinical outcomes in cervical disk replacement surgery. J Spinal Disord Tech. 2015;28(3):106\u2013113. doi:10.1097\/BSD.0b013e31826a0c84"},{"issue":"5","key":"b39","series-title":"J Neurosurg Spine","first-page":"577","article-title":"Is cervical disc arthroplasty good for congenital cervical stenosis","volume":"26","author":"Chang PY","year":"2017","unstructured":"Chang PY, Chang HK, Wu JC,  Is cervical disc arthroplasty good for congenital cervical stenosis? J Neurosurg Spine. 2017;26(5):577\u2013585. doi:10.3171\/2016.10.SPINE16317"},{"issue":"1","key":"b1","series-title":"Neurosurg Clin N Am","first-page":"21","article-title":"The natural history of degenerative cervical myelopathy","volume":"29","author":"Badhiwala JH","year":"2018","unstructured":"Badhiwala JH, Wilson JR. The natural history of degenerative cervical myelopathy. Neurosurg Clin N Am. 2018;29(1):21\u201332. doi:10.1016\/j.nec.2017.09.002"},{"issue":"5","key":"b2","series-title":"J Spinal Disord Tech","first-page":"E251","article-title":"Cervical radiculopathy: epidemiology, etiology, diagnosis, and treatment","volume":"28","author":"Woods BI","year":"2015","unstructured":"Woods BI, Hilibrand AS. Cervical radiculopathy: epidemiology, etiology, diagnosis, and treatment. J Spinal Disord Tech. 2015;28(5):E251\u2013E259. doi:10.1097\/BSD.0000000000000284"},{"issue":"3 Suppl","key":"b3","series-title":"Global Spine J.","first-page":"70S","article-title":"A clinical practice guideline for the management of patients with degenerative cervical myelopathy: recommendations for patients with mild, moderate, and severe disease and nonmyelopathic patients with evidence of cord compression","volume":"7","author":"Fehlings MG","year":"2017","unstructured":"Fehlings MG, Tetreault LA, Riew KD,  A clinical practice guideline for the management of patients with degenerative cervical myelopathy: recommendations for patients with mild, moderate, and severe disease and nonmyelopathic patients with evidence of cord compression. Global Spine J. 2017;7(3 Suppl):70S\u201383S.  doi:10.1177\/2192568217701914"},{"issue":"s2","key":"b4","series-title":"Int J Spine Surg","first-page":"S5","article-title":"Cervical disc arthroplasty: rationale and history","volume":"14","author":"Derman PB","year":"2020","unstructured":"Derman PB, Zigler JE. Cervical disc arthroplasty: rationale and history. Int J Spine Surg. 2020;14(s2):S5-S13. doi:10.14444\/7086"},{"issue":"4","key":"b5","series-title":"J Neurosurg Spine","first-page":"516","article-title":"Clinical and radiographic analysis of an artificial cervical disc: 7-year follow-up from the Prestige prospective randomized controlled clinical trial: clinical article","volume":"21","author":"Burkus JK","year":"2014","unstructured":"Burkus JK, Traynelis VC, Haid RW Jr, Mummaneni PV. Clinical and radiographic analysis of an artificial cervical disc: 7-year follow-up from the Prestige prospective randomized controlled clinical trial: clinical article. J Neurosurg Spine. 2014;21(4):516\u2013528. doi:10.3171\/2014.6.SPINE13996"},{"issue":"1","key":"b6","series-title":"J Neurosurg Spine","first-page":"36","article-title":"Prospective randomized study of cervical arthroplasty and anterior cervical discectomy and fusion with long-term follow-up: results in 74 patients from a single site","volume":"18","author":"Coric D","year":"2013","unstructured":"Coric D, Kim PK, Clemente JD, Boltes MO, Nussbaum M, James S. Prospective randomized study of cervical arthroplasty and anterior cervical discectomy and fusion with long-term follow-up: results in 74 patients from a single site. J Neurosurg Spine. 2013;18(1):36\u201342. doi:10.3171\/2012.9.SPINE12555"},{"issue":"1","key":"b7","series-title":"J Neurosurg Spine","first-page":"15","article-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","volume":"22","author":"Davis RJ","year":"2015","unstructured":"Davis RJ, Nunley PD, Kim KD,  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. J Neurosurg Spine. 2015;22(1):15\u201325. doi:10.3171\/2014.7.SPINE13953"},{"issue":"4","key":"b8","series-title":"J Spinal Disord Tech","first-page":"E237","article-title":"Prospective, randomized comparison of cervical total disk replacement versus anterior cervical fusion: results at 48 months follow-up","volume":"28","author":"Hisey MS","year":"2015","unstructured":"Hisey MS, Bae HW, Davis RJ,  Prospective, randomized comparison of cervical total disk replacement versus anterior cervical fusion: results at 48 months follow-up. J Spinal Disord Tech. 2015;28(4):E237\u2013E243. doi:10.1097\/BSD.0000000000000185"},{"issue":"10","key":"b9","series-title":"Spine (Phila Pa 1976)","first-page":"674","article-title":"Long-term outcomes of the US FDA IDE prospective, randomized controlled clinical trial comparing PCM cervical disc arthroplasty with anterior cervical discectomy and fusion","volume":"40","author":"Phillips FM","year":"2015","unstructured":"Phillips FM, Geisler FH, Gilder KM, Reah C, Howell KM, McAfee PC. Long-term outcomes of the US FDA IDE prospective, randomized controlled clinical trial comparing PCM cervical disc arthroplasty with anterior cervical discectomy and fusion. Spine (Phila Pa 1976). 2015;40(10):674\u2013683. doi:10.1097\/BRS.0000000000000869"},{"issue":"18","key":"b10","series-title":"J Bone Joint Surg Am","first-page":"1684","article-title":"Results of cervical arthroplasty compared with anterior discectomy and fusion: four-year clinical outcomes in a prospective, randomized controlled trial","volume":"93","author":"Sasso RC","year":"2011","unstructured":"Sasso RC, Anderson PA, Riew KD, Heller JG. Results of cervical arthroplasty compared with anterior discectomy and fusion: four-year clinical outcomes in a prospective, randomized controlled trial. J Bone Joint Surg Am. 2011;93(18):1684\u20131692. doi:10.2106\/JBJS.J.00476"},{"issue":"12","key":"b11","series-title":"Int Orthop","first-page":"2533","article-title":"A prospective, randomised, controlled multicentre study comparing cervical disc replacement with anterior cervical decompression and fusion","volume":"38","author":"Zhang HX","year":"2014","unstructured":"Zhang HX, Shao YD, Chen Y,  A prospective, randomised, controlled multicentre study comparing cervical disc replacement with anterior cervical decompression and fusion. Int Orthop. 2014;38(12):2533\u20132541. doi:10.1007\/s00264-014-2497-5"},{"issue":"21","key":"b12","series-title":"Food and Drug Administration Investigational Device Exemption Study. J Bone Joint Surg Am","first-page":"1738","article-title":"ProDisc-C total disc replacement versus anterior cervical discectomy and fusion for single-level symptomatic cervical disc disease: seven-year follow-up of the prospective randomized U.S","volume":"97","author":"Janssen ME","year":"2015","unstructured":"Janssen ME, Zigler JE, Spivak JM, Delamarter RB, Darden BV II, Kopjar B. ProDisc-C total disc replacement versus anterior cervical discectomy and fusion for single-level symptomatic cervical disc disease: seven-year follow-up of the prospective randomized U.S. Food and Drug Administration Investigational Device Exemption Study. J Bone Joint Surg Am. 2015;97(21):1738\u20131747. doi:10.2106\/JBJS.N.01186"},{"issue":"7","key":"b13","series-title":"Spine J","first-page":"1026","article-title":"Cervical disc arthroplasty: do conflicts of interest influence the outcome of clinical studies","volume":"17","author":"Narain AS","year":"2017","unstructured":"Narain AS, Hijji FY, Yom KH, Kudaravalli KT, Singh K. Cervical disc arthroplasty: do conflicts of interest influence the outcome of clinical studies? Spine J. 2017;17(7):1026\u20131032. doi:10.1016\/j.spinee.2017.03.018"},{"issue":"6","key":"b14","series-title":"Spine J","first-page":"965","article-title":"The NECK trial: effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; a double-blinded randomized controlled trial","volume":"19","author":"Vleggeert-Lankamp CLA","year":"2019","unstructured":"Vleggeert-Lankamp CLA, Janssen TMH, van Zwet E,  The NECK trial: effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; a double-blinded randomized controlled trial. Spine J. 2019;19(6):965\u2013975. doi:10.1016\/j.spinee.2018.12.013"},{"key":"b15","series-title":"World Neurosurg","first-page":"116","article-title":"Multilevel cervical arthroplasty: expanding indications","volume":"164","author":"Schupper AJ","year":"2022","unstructured":"Schupper AJ, Steinberger J, Gologorsky Y. Multilevel cervical arthroplasty: expanding indications. World Neurosurg. 2022;164:116. doi:10.1016\/j.wneu.2022.04.076"},{"issue":"9","key":"b16","series-title":"Clin Spine Surg","first-page":"375","article-title":"Current and expanded indications for cervical disc arthroplasty: beyond the FDA IDE studies","volume":"36","author":"Divi SN","year":"2023","unstructured":"Divi SN, Plantz MA, Tegethoff J, Su BW. Current and expanded indications for cervical disc arthroplasty: beyond the FDA IDE studies. Clin Spine Surg. 2023;36(9):375\u2013385. doi:10.1097\/BSD.0000000000001525"},{"key":"b17","year":"2019","unstructured":"Summary of safety and effectiveness data (P170036B). M6-C Artificial Cervical Disc. US Food & Drug Administration; 2019.Accessed May 27, 2026.https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf17\/P170036B.pdf"},{"key":"b18","year":"2009","unstructured":"Summary of safety and effectiveness data (P060023C). BRYAN Cervical Disc. US Food & Drug Administration; 2009.Accessed May 27, 2026.https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf6\/p060023c.pdf"},{"key":"b19","year":"2013","unstructured":"Summary of safety and effectiveness data (P110002B). Mobi-C Cervical Disc Prosthesis. US Food & Drug Administration; 2013.Accessed May 27, 2026.https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf11\/p110002b.pdf"},{"key":"b20","year":"2012","unstructured":"Summary of safety and effectiveness data (P100012B). PCM Cervical Disc. US Food & Drug Administration; 2012.Accessed May 27, 2026.https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf10\/p100012b.pdf"},{"key":"b21","year":"2007","unstructured":"Summary of safety and effectiveness data (P070001B). ProDisc-C Total Disc Replacement. US Food & Drug Administration; 2007.Accessed May 27, 2026.https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf10\/p100012b.pdf"},{"key":"b22","year":"2012","unstructured":"Summary of safety and effectiveness data (P100003B). SECURE-C Cervical Artificial Disc. US Food & Drug Administration; 2012.Accessed May 27, 2026.https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf10\/p100003b.pdf"},{"key":"b23","year":"2020","unstructured":"Summary of safety and effectiveness data (P200022B). Simplify Cervical Artificial Disc. US Food & Drug Administration; 2020.Accessed May 27, 2026.https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf20\/P200022B.pdf"},{"key":"b24","year":"2014","unstructured":"Summary of safety and effectiveness data (P090029B). PRESTIGE LP Cervical Disc. US Food & Drug Administration; 2014.Accessed May 27, 2026.https:\/\/www.goohttps:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf9\/p090029b.pdf"},{"issue":"7","key":"b25","series-title":"Clin Spine Surg","first-page":"E283","article-title":"Trends in indications and contraindications for cervical disk arthroplasty from 2009 to 2019","volume":"37","author":"Shafi K","year":"2024","unstructured":"Shafi K, Du JY, Blackburn CW,  Trends in indications and contraindications for cervical disk arthroplasty from 2009 to 2019. Clin Spine Surg. 2024;37(7):E283\u2013E289. doi:10.1097\/BSD.0000000000001589"},{"issue":"3","key":"b26","series-title":"Spine (Phila Pa 1976)","first-page":"249","article-title":"Utilization trends of cervical artificial disc replacement after FDA approval compared with anterior cervical fusion: adoption of new technology","volume":"39","author":"Lu Y","year":"2014","unstructured":"Lu Y, McAnany SJ, Hecht AC, Cho SK, Qureshi SA. Utilization trends of cervical artificial disc replacement after FDA approval compared with anterior cervical fusion: adoption of new technology. Spine (Phila Pa 1976). 2014;39(3):249\u2013255. doi:10.1097\/BRS.0000000000000113"},{"issue":"3","key":"b27","series-title":"Neurosurg Focus","first-page":"E1","article-title":"Historical review of cervical arthroplasty","volume":"17","author":"Le H","year":"2004","unstructured":"Le H, Thongtrangan I, Kim DH. Historical review of cervical arthroplasty. Neurosurg Focus. 2004;17(3):E1. doi:10.3171\/foc.2004.17.3.1"},{"issue":"3","key":"b28","series-title":"J Neurosurg Spine","first-page":"198","article-title":"Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial","volume":"6","author":"Mummaneni PV","year":"2007","unstructured":"Mummaneni PV, Burkus JK, Haid RW, Traynelis VC, Zdeblick TA. Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial. J Neurosurg Spine. 2007;6(3):198\u2013209. doi:10.3171\/spi.2007.6.3.198"},{"issue":"2","key":"b29","series-title":"Spine J","first-page":"210","article-title":"Should patient eligibility criteria for cervical disc arthroplasty (CDA) be expanded? A retrospective cohort analysis of relatively contraindicated patients undergoing CDA","volume":"24","author":"Patel N","year":"2024","unstructured":"Patel N, Abdelmalek G, Coban D,  Should patient eligibility criteria for cervical disc arthroplasty (CDA) be expanded? A retrospective cohort analysis of relatively contraindicated patients undergoing CDA. Spine J. 2024;24(2):210\u2013218. doi:10.1016\/j.spinee.2023.09.017"},{"issue":"s2","key":"b30","series-title":"Int J Spine Surg","first-page":"S29","article-title":"Patient selection in cervical disc arthroplasty","volume":"14","author":"Nunley P","year":"2020","unstructured":"Nunley P, Frank K, Stone M. Patient selection in cervical disc arthroplasty. Int J Spine Surg. 2020;14(s2):S29-S35. doi:10.14444\/7088"},{"issue":"5","key":"b31","series-title":"Spine J","first-page":"711","article-title":"The prevalence of indications and contraindications to cervical total disc replacement","volume":"8","author":"Auerbach JD","year":"2008","unstructured":"Auerbach JD, Jones KJ, Fras CI, Balderston JR, Rushton SA, Chin KR. The prevalence of indications and contraindications to cervical total disc replacement. Spine J. 2008;8(5):711\u2013716. doi:10.1016\/j.spinee.2007.06.018"},{"issue":"11","key":"b32","series-title":"Spine (Phila Pa 1976)","first-page":"978","article-title":"Differences in the surgical treatment of lower back pain among spine surgeons in the United States","volume":"41","author":"Lubelski D","year":"2016","unstructured":"Lubelski D, Williams SK, O\u2019Rourke C,  Differences in the surgical treatment of lower back pain among spine surgeons in the United States. Spine (Phila Pa 1976). 2016;41(11):978\u2013986. doi:10.1097\/BRS.0000000000001396"},{"issue":"12","key":"b33","series-title":"Spine (Phila Pa 1976)","first-page":"1337","article-title":"Superiority of multilevel cervical arthroplasty outcomes versus single-level outcomes: 229 consecutive PCM prostheses","volume":"32","author":"Pimenta L","year":"2007","unstructured":"Pimenta L, McAfee PC, Cappuccino A, Cunningham BW, Diaz R, Coutinho E. Superiority of multilevel cervical arthroplasty outcomes versus single-level outcomes: 229 consecutive PCM prostheses. Spine (Phila Pa 1976). 2007;32(12):1337\u20131344. doi:10.1097\/BRS.0b013e318059af12"},{"key":"b34","series-title":"World Neurosurg","first-page":"e151","article-title":"Is cervical disc replacement valuable in 3-level hybrid surgery compared with 3-level anterior cervical discectomy and fusion","volume":"146","author":"Wang H","year":"2021","unstructured":"Wang H, Huang K, Liu H,  Is cervical disc replacement valuable in 3-level hybrid surgery compared with 3-level anterior cervical discectomy and fusion? World Neurosurg. 2021;146:e151\u2013e160. doi:10.1016\/j.wneu.2020.10.057"},{"issue":"6","key":"b35","series-title":"J Neurosurg Spine","first-page":"653","article-title":"Cervical disc arthroplasty with the Prestige LP disc versus anterior cervical discectomy and fusion, at 2 levels: results of a prospective, multicenter randomized controlled clinical trial at 24 months","volume":"26","author":"Gornet MF","year":"2017","unstructured":"Gornet MF, Lanman TH, Burkus JK,  Cervical disc arthroplasty with the Prestige LP disc versus anterior cervical discectomy and fusion, at 2 levels: results of a prospective, multicenter randomized controlled clinical trial at 24 months. J Neurosurg Spine. 2017;26(6):653\u2013667. doi:10.3171\/2016.10.SPINE16264"},{"issue":"4","key":"b36","series-title":"Int J Spine Surg","first-page":"483","article-title":"Restoration of spinal motion: conversion of anterior cervical fusion with pseudarthrosis to artificial disc replacement","volume":"14","author":"Lanman TH","year":"2020","unstructured":"Lanman TH, Cu\u00c9llar JM. Restoration of spinal motion: conversion of anterior cervical fusion with pseudarthrosis to artificial disc replacement. Int J Spine Surg. 2020;14(4):483\u2013487. doi:10.14444\/7063"},{"key":"b37","series-title":"Clin Neurol Neurosurg","first-page":"59","article-title":"Cervical arthroplasty versus anterior cervical fusion for symptomatic adjacent segment disease after anterior cervical fusion surgery: review of treatment in 41 patients","volume":"162","author":"Lee SB","year":"2017","unstructured":"Lee SB, Cho KS. Cervical arthroplasty versus anterior cervical fusion for symptomatic adjacent segment disease after anterior cervical fusion surgery: review of treatment in 41 patients. Clin Neurol Neurosurg. 2017;162:59\u201366. doi:10.1016\/j.clineuro.2017.08.001"},{"issue":"3","key":"b38","series-title":"J Spinal Disord Tech","first-page":"106","article-title":"Radiographic variables that may predict clinical outcomes in cervical disk replacement surgery","volume":"28","author":"Rihn JA","year":"2015","unstructured":"Rihn JA, Radcliff K, Hipp J,  Radiographic variables that may predict clinical outcomes in cervical disk replacement surgery. J Spinal Disord Tech. 2015;28(3):106\u2013113. doi:10.1097\/BSD.0b013e31826a0c84"},{"issue":"5","key":"b39","series-title":"J Neurosurg Spine","first-page":"577","article-title":"Is cervical disc arthroplasty good for congenital cervical stenosis","volume":"26","author":"Chang PY","year":"2017","unstructured":"Chang PY, Chang HK, Wu JC,  Is cervical disc arthroplasty good for congenital cervical stenosis? J Neurosurg Spine. 2017;26(5):577\u2013585. doi:10.3171\/2016.10.SPINE16317"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/61\/1\/article-pE2.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/61\/1\/article-pE2.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/61\/1\/article-pE2.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:55Z","timestamp":1783468855000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/61\/1\/article-pE2.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":78,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2026.3.focus251101","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,1]]}}}