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Cervical disk arthroplasty: The new gold standard?
Stephane Owusu-Sarpong1, Nathan Kim, Yong Kim
1Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, New York.
Bulletin of the Hospital for Joint Disease (2013)
|February 4, 2026
Summary
Cervical disk arthroplasty (CDA) shows long-term superiority over anterior cervical diskectomy and fusion (ACDF) in preventing adjacent segment disease. While ACDF remains a standard, CDA offers a promising alternative for cervical spondylosis management.
Area of Science:
- Orthopedics
- Neurosurgery
- Spine Surgery
Background:
- Cervical spondylosis involves degenerative changes in the cervical spine, causing neck pain, myelopathy, and radiculopathy.
- Anterior cervical diskectomy and fusion (ACDF) is the standard surgical treatment but carries risks like pseudarthrosis and adjacent segment disease (ASD).
- Cervical disk arthroplasty (CDA) emerged as an alternative to fusion, aiming to preserve motion and reduce ASD risk, though it has risks like heterotopic ossification.
Purpose of the Study:
- To compare the long-term efficacy and safety of cervical disk arthroplasty (CDA) versus anterior cervical diskectomy and fusion (ACDF) for treating cervical spondylosis.
- To evaluate the incidence of adjacent segment disease (ASD) and other complications associated with both CDA and ACDF over extended follow-up periods.
- To assess the evolving role of CDA in clinical practice given emerging long-term data.
Main Methods:
- Review of long-term follow-up studies (up to 20 years) comparing CDA and ACDF.
- Analysis of complication rates, including pseudarthrosis, adjacent segment disease (ASD), and heterotopic ossification.
- Comparative assessment of patient outcomes and surgical success between the two procedures.
Main Results:
- Long-term studies (up to 20 years) suggest CDA may have lower rates of adjacent segment disease (ASD) compared to ACDF.
- While ACDF remains a gold standard, CDA demonstrates comparable or superior long-term outcomes in certain aspects.
- CDA is associated with heterotopic ossification, a complication not seen with ACDF.
Conclusions:
- Cervical disk arthroplasty (CDA) presents a viable alternative to ACDF, with evidence suggesting potential long-term benefits in reducing adjacent segment disease (ASD).
- Despite its advantages, the role of fusion (ACDF) persists in specific clinical scenarios for managing cervical spine pathologies.
- Continued research and long-term data are crucial for refining treatment paradigms in cervical spondylosis management.
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