Search research articles

ABOUT JoVE

Overview Leadership Blog JoVE Help Center

AUTHORS

Publishing Process Editorial Board Scope & Policies Peer Review FAQ Submit

LIBRARIANS

Testimonials Subscriptions Access Resources Library Advisory Board FAQ

RESEARCH

JoVE Journal Methods Collections JoVE Encyclopedia of Experiments Archive

EDUCATION

JoVE Core JoVE Business JoVE Science Education JoVE Lab Manual Faculty Resource Center Faculty Site

Terms & Conditions of Use

Search research articles

Related Experiment Video

Updated: Oct 19, 2025

Author Spotlight: Development and Application of a Novel Suture Technique for Annular Fibrosus Repair in Percutaneous Transforaminal Endoscopic Discectomy

Author Spotlight: Development and Application of a Novel Suture Technique for Annular Fibrosus Repair in Percutaneous Transforaminal Endoscopic Discectomy

Published on: January 26, 2024

Cervical Total Disc Replacement: Expanded Indications.

Óscar L Alves¹

¹Hospital Lusíadas Porto; Centro Hospitalar de Gaia/Espinho, Rua Cónego Ferreira Pinto, 191, 4050-256 Porto, Portugal.

Neurosurgery Clinics of North America

|September 20, 2021

Summary

This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by

Same author

Transforaminal Endoscopic Lumbar Decompression: Defining Its Scope and Limitations.

International journal of spine surgery·2026

Same author

Unilateral Accessory Articular Facet at C1 to C2.

International journal of spine surgery·2026

Same author

The Future of Endoscopic Spine Surgery in the United States: Lifeline or Liability?

International journal of spine surgery·2026

Same author

ISASS Brave New Continuing Medical Education World: The Stifling of Innovation in Spine Surgery Through Overrestriction of Collaboration.

International journal of spine surgery·2026

Same author

Precision Redefined: Robotics and Navigation in Spine Surgery - A Leap Forward or a Technology in Search of Purpose?

Spine·2026

Same author

Neurogenetics and Epigenetics of Spirituality and Religion: Seeking Genospirituality Via the Lens of Hierarchical Neuro-Spiritual Model (HNSM).

Neurology (E-Cronicon)·2026

Same journal

Intramedullary Spinal Cord Tumors.

Neurosurgery clinics of North America·2026

Same journal

Spinal Cord Deformities Associated with Intramedullary Spinal Cord Tumors.

Neurosurgery clinics of North America·2026

Same journal

Radiation Therapy for Spinal Cord Tumors.

Neurosurgery clinics of North America·2026

Same journal

Treatment Strategies of Intramedullary Spinal Cord Tumors.

Neurosurgery clinics of North America·2026

Same journal

Vascular Lesions of the Spinal Cord: Arteriovenous and Cavernous Malformations.

Neurosurgery clinics of North America·2026

Same journal

Hemangioblastomas of the Spinal Cord.

Neurosurgery clinics of North America·2026

See all related articles

Cervical total disc replacement (cTDR) is a safe and effective alternative to anterior cervical discectomy and fusion (ACDF) for one- or two-level degenerative disc disease. This review examines evidence for expanding cTDR to three- or four-level disease.

Area of Science:

Orthopedics
Neurosurgery
Spinal Surgery

Background:

Cervical total disc replacement (cTDR) is established as a safe and effective alternative to anterior cervical discectomy and fusion (ACDF) for 1- or 2-level degenerative disc disease (DDD).
cTDR demonstrates comparable or superior clinical outcomes compared to ACDF in long-term follow-up (10-15 years).
Multilevel ACDF presents limitations and exacerbates complications, creating a need for alternative treatments for extensive cervical DDD.

Purpose of the Study:

To analyze current evidence supporting the expanded indication of cTDR for 3- and 4-level degenerative disc disease.
To evaluate the clinical safety, efficacy, and cost-effectiveness of multilevel cTDR.
To assess the role of cTDR as a stand-alone procedure or adjacent to fusion in multilevel cervical pathology.

Keywords:

3- or 4-level cervical disc arthroplasty ACDF Cervical artificial disc Cervical motion preservation Cervical spondylotic myelopathy Degenerative disc disease Multilevel cervical total disc replacement Off-label spine surgery

More Related Videos

A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations

A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations

Published on: August 7, 2018

Related Experiment Videos

Last Updated: Oct 19, 2025

Author Spotlight: Development and Application of a Novel Suture Technique for Annular Fibrosus Repair in Percutaneous Transforaminal Endoscopic Discectomy

Author Spotlight: Development and Application of a Novel Suture Technique for Annular Fibrosus Repair in Percutaneous Transforaminal Endoscopic Discectomy

Published on: January 26, 2024

A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations

A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations

Published on: August 7, 2018

Main Methods:

Systematic review of published literature and clinical trial data.
Analysis of evidence from a European perspective with potentially less stringent regulatory requirements.
Evaluation of studies comparing multilevel cTDR with multilevel ACDF.

Main Results:

cTDR shows consistent safety and efficacy for 1- or 2-level DDD compared to ACDF.
Evidence regarding the safety, efficacy, and cost-effectiveness of multilevel cTDR is still under investigation.
Multilevel ACDF is associated with known limitations and potential complications.

Conclusions:

While cTDR is a proven option for lower-level DDD, its application in 3- and 4-level disease requires further establishment.
The clinical utility of multilevel cTDR, alone or combined with fusion, needs comprehensive evaluation.
Further research is essential to confirm the benefits and address the constraints of expanding cTDR to more extensive cervical degenerative conditions.