Abstract
Anterior cervical discectomy and fusion (ACDF) has a long track record of pain relief and positive patient-reported outcomes for patients with degenerative disc disease and spondylosis. However, there is a growing desire to preserve motion while relieving pain to prevent future adjacent segment degeneration and pseudoarthrosis. An FDA-approved treatment that has been growing in popularity recently is cervical total disc arthroplasty (TDA), which has proven positive long-term outcomes with strict adherence to indications and contraindications. Patients with single-level and two-level cervical disease should be assessed for infection, osteoporosis, axial neck pain, severe spondylosis or instability, facet arthropathy, less than 3 mm of disc space, and greater than 15° of kyphotic deformity since these are all contraindications to the procedure. In a few randomized controlled trials comparing ACDF and cervical TDA, arthroplasty has demonstrated superiority as far out as 10 years. © Springer Nature Switzerland AG 2020.