Trends in Cervical Disk Arthroplasty Utilization in the Medicare Population: Projections Through 2040

Cervical disk arthroplasty (CDA) has emerged as a motion-preserving alternative to anterior cervical diskectomy and fusion, offering the potential to reduce adjacent segment degeneration while maintaining cervical spine mobility. Although previous studies have highlighted the increasing adoption of CDA, trends within the broader Medicare population, including those enrolled in Medicare Advantage (MA), remain less defined. This study retrospectively analyzed Medicare Part B National Summary data from 2009 to 2022 to assess historical utilization patterns of single-level and multilevel CDA and applied statistical modeling to project future procedure volumes through 2040.

Medicare Part B National Summary data from 2009 to 2022 were analyzed to quantify single-level and multilevel CDA procedure volumes. Data adjustments accounted for MA enrollment using established correction factors. Forecasting models-including log-linear, Poisson, negative binomial regression, and autoregressive integrated moving average-were applied to project utilization trends. Model performance was assessed using mean absolute error and root mean square error. The Poisson regression model was selected for final projections due to its optimal balance of predictive accuracy and stability.

From 2009 to 2022, single-level CDA volume increased by 1,454% (108 to 1,679 cases), while multilevel CDA volume grew by 609.5% from 2015 to 2022 (147 to 1,042 cases). Forecasting projected a 23.5% annual growth rate for single-level CDA and 24.4% for multilevel CDA through 2040. By 2040, single-level CDA is expected to reach 96,430 procedures annually (95% confidence interval, 95,822 to 97,039), while multilevel CDA will reach 63,362 procedures (95% confidence interval, 62,869 to 63,856).

CDA utilization among all Medicare beneficiaries, including those enrolled in MA, has grown substantially and is projected to continue increasing through 2040. These trends reflect rising demand for motion-preserving cervical spine procedures and highlight the importance of healthcare planning, surgeon training, and equitable reimbursement policies to accommodate future growth.