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Related Experiment Video

Updated: Jul 16, 2025

Anterior Cervical Discectomy and Fusion in the Ovine Model
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Multilevel Cervical Disk Arthroplasty: Moving Beyond Two Levels.

Aditya Muralidharan1, Davin Gong1, Joshua D Piche1

  • 1Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI.

Clinical Spine Surgery
|September 9, 2023
PubMed
Summary

Multilevel cervical disk arthroplasty (CDA) offers promising results for specific patients as an alternative to anterior cervical discectomy and fusion (ACDF). Careful patient selection is crucial for optimal outcomes in this evolving procedure.

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Spinal Surgery

Background:

  • Cervical disk arthroplasty (CDA) is established for 1- and 2-level cervical pathology.
  • Increasing utilization of multilevel CDA for >2-level disease as an alternative to anterior cervical discectomy and fusion (ACDF).

Purpose of the Study:

  • Evaluate the efficacy and safety of multilevel CDA.
  • Compare multilevel CDA outcomes to ACDF.
  • Identify patient indications and contraindications for multilevel CDA.

Main Methods:

  • Review of prospective studies and randomized trials on multilevel CDA.
  • Analysis of patient selection criteria and outcomes.
  • Comparison of complication rates and functional scores between CDA and ACDF.

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Last Updated: Jul 16, 2025

Anterior Cervical Discectomy and Fusion in the Ovine Model
06:11

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Published on: October 5, 2009

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Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
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Main Results:

  • Multilevel CDA shows promising results in appropriately selected patients without extensive facet arthropathy.
  • Similar risk profiles to ACDF, with potentially lower rates of pseudarthrosis and adjacent segment disease.
  • Preserved or increased cervical range of motion; negligible differences in postoperative pain and functional scores compared to ACDF.

Conclusions:

  • Multilevel CDA is a viable option for select patients with multilevel cervical disc disease.
  • Contraindications include prior spinal trauma, significant spondylolisthesis, facet arthropathy, and kyphotic deformity.
  • Continued research and prosthesis advancements are expected to expand indications for multilevel CDA.