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Neurosurgery149 papers

Degenerative cervical spinal stenosis

Last edited: 4/13/2026

Overview

Degenerative cervical spinal stenosis involves narrowing of the spinal canal in the neck, often due to disc herniation, osteophyte formation, and facet joint hypertrophy, leading to radiculopathy or myelopathy symptoms.

Diagnosis

Clinical Presentation: Neck pain, radicular symptoms (arm pain, weakness, numbness), and/or gait disturbances 1.

Imaging Studies: MRI is essential for detailed assessment of spinal cord compression, disc herniations, and osteophyte formation 1 3.

Grading: Utilize the Spinal Cord Independence Measure (SCIM) or Nurick scale for myelopathy severity 1.

Management

Surgical Options:

- Anterior Cervical Discectomy and Fusion (ACDF): Standard procedure for decompression and stabilization 2 3 10 20. - Cervical Disc Arthroplasty (CDA): Alternative to ACDF, preserving motion at the operated level 5 13 28 31.

Non-Surgical Management: Physical therapy, pain management, and activity modification for mild cases 1.

Special Populations

Elderly Patients: ACDF remains prevalent, but CDA shows comparable outcomes with less adjacent segment disease risk 28 31.

Osteoporosis: Zero-profile devices may offer advantages in geriatric osteoporotic patients due to reduced bone loss and better fusion rates 7.

Key Recommendations

Consider Cervical Disc Arthroplasty (CDA) over ACDF for Single-Level Disease: CDA preserves motion and may reduce adjacent segment disease risk in appropriately selected patients (Evidence: Moderate 5 13).

Use Zero-Profile Devices in Osteoporotic Patients: These devices may minimize complications like bone loss and improve fusion outcomes in geriatric populations (Evidence: Moderate 7).

Monitor for Adjacent Segment Disease (ASD): Regular follow-up imaging is crucial, especially after fusion procedures, to detect early signs of ASD (Evidence: Expert opinion 4 11).

Evaluate Facet Distraction Distance (FDD) in ACDF: Higher FDD correlates with increased risk of cage subsidence, influencing surgical technique (Evidence: Moderate 8).

Consider Patient-Specific Factors in Surgical Choice: Decision-making should incorporate patient age, bone quality, and lifestyle to optimize outcomes (Evidence: Expert opinion 1).

References

Showing 100 most recent of 107 indexed papers.

1 Shafi KA, Lui ATH, Mikhail C, Morse K, Zhang J, Kwas C et al.. Contemporary decision-making factors leading to cervical disc replacement versus fusion for the treatment of single-level degenerative cervical radiculopathy or myelopathy: survey opinions from members of the society of minimally invasive spine surgeon and cervical spine research society. The spine journal : official journal of the North American Spine Society 2026. link 2 Gerdhem L, Vlachogiannis P, Gerdhem P, MacDowall A. Cage only or cage with plate fixation in anterior cervical discectomy and fusion surgery - analysis of a national multicenter dataset. The spine journal : official journal of the North American Spine Society 2025. link 3 Zong R, Liu CY, Jin YZ, Peng ZH, He JB, Wu TK et al.. Anterior bone loss after anterior cervical discectomy and fusion: influence factors and its impact on surgical outcomes. BMC musculoskeletal disorders 2025. link 4 Wang F, Lu J, Wang B, Zhu Z, Shen B, Guo K et al.. Is screw position a greater contributor to adjacent segment disease than plate-to-disc distance following anterior cervical discectomy and fusion?. BMC musculoskeletal disorders 2025. link 5 Zhang Y, Ju J, Wu J. Comparison of cervical disc arthroplasty versus anterior cervical discectomy and fusion for the treatment of single-segment cervical degenerative disc disease with a minimum of 4-year follow-up: a systematic review and meta-analysis of randomized controlled trials. Journal of orthopaedic surgery and research 2025. link 6 Xu X, Guo X, Zhou Q, Song Z. Efficacy and safety of ROI-C™ self-locking system versus cage combined with screw-plate internal fixation in the treatment of degenerative cervical disease: A meta-analysis. Medicine 2025. link 7 Guo Y, Xie Q, Xu Q, Li D, Wang A, Liu Y et al.. Zero-profile devices versus traditional cage-plate systems for geriatric osteoporotic patients with cervical degenerative disc disease: a retrospective analysis of 190 patients. European journal of medical research 2025. link 8 Zhao C, Wang S, Zhang J, Niu H, Cao Y, Shen C et al.. Facet Distraction Distance Independently Predicts Cage Subsidence Following Anterior Cervical Discectomy and Fusion. World neurosurgery 2025. link 9 Leonova O, Baykov E, Krutko A. A Strong Association Between Modic Changes Type 2 and Endplate Defects at Nonfused Segments After Anterior Cervical Decompression and Fusion. World neurosurgery 2025. link 10 Wang XJ, He JB, Wu TK, Wang BY, Rong X, Gong Q et al.. The Influence of Zero-Profile Implant Selection on the Outcomes of Anterior Cervical Discectomy and Fusion. Orthopaedic surgery 2025. link 11 Li J, Wu Y, Liu H, Guo C, Zhang J, Huang K et al.. Does two-level hybrid surgery promote early fusion compared with two-level anterior cervical discectomy and fusion?. The spine journal : official journal of the North American Spine Society 2025. link 12 Kumar R, Kumar A, Kumari S. Biomechanical analysis of single and multi-level artificial disc replacement (ADR) in cervical spine using multi-scale loadings: A finite element study. The International journal of artificial organs 2024. link 13 Quinto ES, Paisner ND, Huish EG, Senegor M. Ten-Year Outcomes of Cervical Disc Arthroplasty Versus Anterior Cervical Discectomy and Fusion : A Systematic Review With Meta-Analysis. Spine 2024. link 14 Wu T, Wang H, Huang K, He J, Yan C, Ding C et al.. Risk factors of bone loss after Prestige-LP cervical disc arthroplasty. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2024. link 15 Li J, Deng Y, Zhang J, Wang B, Huang K, Liu H et al.. Combined effect of artificial cervical disc replacement and facet tropism on the index-level facet joints: a finite element study. BMC musculoskeletal disorders 2024. link 16 Vijaya Saradhi M, Sashanka K, Alugolu R. Does the extent of soft tissue dissection and location of screws in anterior cervical discectomy and fusion impact the development of the adjacent segment degeneration? A prospective short-term radiological analysis. Journal of neurosurgical sciences 2024. link 17 Katuch V, Banoci J, Magocova V, Cmorej M, Katuchova J, Efthymiou K et al.. Postoperative complications associated with anterior cervical discectomy and three years follow-up. Bratislavske lekarske listy 2024. link 18 Altorfer FCS, Kelly MJ, Avrumova F, Zhu J, Abjornson C, Lebl DR. Reasons for Revision Surgery After Cervical Disk Arthroplasty Based on Medical Device Reports Maintained by the US Food and Drug Administration. Spine 2024. link 19 Ortiz-Babilonia CD, Gupta A, Cartagena-Reyes MA, Xu AL, Raad M, Durand WM et al.. The Statistical Fragility of Trials Comparing Cervical Disc Arthroplasty and Anterior Cervical Discectomy and Fusion: A Meta Analysis. Spine 2024. link 20 Balakumar B, Raju S, Marconi SD, Hassan MF. A pragmatic single centre retrospective comparative review of complication profile between PEEK cages and Zero-P cage screw constructs. British journal of neurosurgery 2024. link 21 Chen SH, Li YL, Liu H, Wu TK, Huang KK, Yao MH et al.. Overloaded Vertebral Body Following Consecutive Three-Level Hybrid Surgery Comparing with Anterior Cervical Discectomy and Fusion. Orthopaedic surgery 2024. link 22 Roth SG, Robles Ortiz MJ, Vulapalli M, Riew KD. Revision Strategies for Cervical Disc Arthroplasty. Clinical spine surgery 2023. link 23 Ye J, Sasso W, Boody B, Sasso R. Technique Pearls for Successful Cervical Disc Arthroplasty From More Than 20 Years of Surgical Experience. Clinical spine surgery 2023. link 24 Chen S, Deng Y, Liu H, Wu T, Huang K, He J et al.. Cervical sagittal balance after consecutive three-level hybrid surgery versus anterior cervical discectomy and fusion: radiological results from a single-center experience. Journal of orthopaedic surgery and research 2023. link 25 Clohisy JCF, Maayan O, Asada T, Qureshi SA. Cervical Total Disc Replacement in Athletes: A Systematic Review. Clinical spine surgery 2023. link 26 Wu TK, He JB, Huang KK, Rong X, Ding C, Wang BY et al.. Cervical Disc Arthroplasty for the Treatment of Noncontiguous Cervical Degenerative Disc Disease: Results of Mid- to Long-Term Follow-up. Orthopaedic surgery 2023. link 27 Zou L, Liu H, Rong X, Liu X, Ding C, Song Y. Long-term Follow-Up Results of Dynamic Cervical Implant in Patients with Cervical Disk Diseases: Compared with Arthroplasty. Journal of neurological surgery. Part A, Central European neurosurgery 2023. link 28 Hirvonen T, Hämäläinen M, Konsti J, Antinheimo J, Numminen J, Siironen J et al.. Comparable long-term outcomes in patients undergoing total disc replacement or anterior cervical discectomy and noninstrumented fusion. The spine journal : official journal of the North American Spine Society 2023. link 29 Steib JP, Dufour T, Beaurain J, Bernard P, Huppert J. Observational, Multicenter Study of the Efficacy and Safety of Cervical Disk Arthroplasty With Mobi-C in the Treatment of Cervical Degenerative Disk Disease. Results at 10 years Follow-Up. Spine 2023. link 30 Schuermans VNE, Smeets AYJM, Boselie TFM, Candel MJJM, Curfs I, Evers SMAA et al.. Research protocol: Cervical Arthroplasty Cost Effectiveness Study (CACES): economic evaluation of anterior cervical discectomy with arthroplasty (ACDA) versus anterior cervical discectomy with fusion (ACDF) in the surgical treatment of cervical degenerative disc disease - a randomized controlled trial. Trials 2022. link 31 Ostrov PB, Reddy AK, Ryoo JS, Behbahani M, Mehta AI. Anterior Cervical Discectomy and Fusion Versus Cervical Disc Arthroplasty: A Comparison of National Trends and Outcomes. World neurosurgery 2022. link 32 Huang K, Wang H, Liu H, Meng Y, Ding C, Wang B et al.. Classification of three-level hybrid surgery for the treatment of cervical degenerative disc disease: a retrospective study of 108 patients. BMC surgery 2022. link 33 Choi J, Park HB, Lim T, Yi SW, Lee S, Park S et al.. Best cutoff score of cervical-pedicle thickness as a morphological parameter for predicting cervical central stenosis. Medicine 2022. link 34 Peng Z, Hong Y, Meng Y, Liu H. A meta-analysis comparing the short- and mid- to long-term outcomes of artificial cervical disc replacement(ACDR) with anterior cervical discectomy and fusion (ACDF) for the treatment of cervical degenerative disc disease. International orthopaedics 2022. link 35 Rossi V, Adamson T. Cervical Spine Surgery: Arthroplasty Versus Fusion Versus Posterior Foraminotomy. Neurosurgery clinics of North America 2021. link 36 Ricciardi L, Scerrati A, Bonis P, Miscusi M, Trungu S, Visocchi M et al.. Long-term Radiologic and Clinical Outcomes after Three-level Contiguous Anterior Cervical Diskectomy and Fusion without Plating: A Multicentric Retrospective Study. Journal of neurological surgery. Part A, Central European neurosurgery 2021. link 37 Zhu C, He M, Mao L, Li T, Zhang L, Liu L et al.. Titanium-interlayer mediated hydroxyapatite coating on polyetheretherketone: a prospective study in patients with single-level cervical degenerative disc disease. Journal of translational medicine 2021. link 38 Shin JJ, Kim KR, Son DW, Shin DA, Yi S, Kim KN et al.. Cervical disc arthroplasty: What we know in 2020 and a literature review. Journal of orthopaedic surgery (Hong Kong) 2021. link 39 Choi BW, Choi MS, Chang H. Radiological Assessment of the Effects of Anterior Cervical Discectomy and Fusion on Distraction of the Posterior Ligamentum Flavum in Patients with Degenerative Cervical Spines. Clinics in orthopedic surgery 2021. link 40 Yang SH, Xiao FR, Lai DM, Wei CK, Tsuang FY. A Dynamic Interbody Cage Improves Bone Formation in Anterior Cervical Surgery: A Porcine Biomechanical Study. Clinical orthopaedics and related research 2021. link 41 Kumar C, Dietz N, Sharma M, Wang D, Ugiliweneza B, Boakye M. Long-Term Comparison of Health Care Utilization and Reoperation Rates in Patients Undergoing Cervical Disc Arthroplasty and Anterior Cervical Discectomy and Fusion for Cervical Degenerative Disc Disease. World neurosurgery 2020. link 42 Harris AB, Marrache M, Jami M, Raad M, Puvanesarajah V, Hassanzadeh H et al.. Chronic opioid use following anterior cervical discectomy and fusion surgery for degenerative cervical pathology. The spine journal : official journal of the North American Spine Society 2020. link 43 Wang X, Meng Y, Liu H, Hong Y, Wang B. Comparison of the safety of outpatient cervical disc replacement with inpatient cervical disc replacement: A protocol for a meta-analysis. Medicine 2020. link 44 Wang H, Meng Y, Liu H, Wang X, Ding C. A Comparison of 2 Anterior Hybrid Techniques for 3-Level Cervical Degenerative Disc Disease. Medical science monitor : international medical journal of experimental and clinical research 2020. link 45 Brotzki C, Petridis AK, Steiger HJ, Bostelmann T, Bostelmann R. Comparison of Different Hybrid Techniques for the Treatment of Multilevel Cervical Degenerative Disc Disease-Analysis of Prospectively Collected Clinical, Radiologic, and Psychological Parameters. World neurosurgery 2020. link 46 Zhai S, Li A, Li X, Wu X. Total disc replacement compared with fusion for cervical degenerative disc disease: A systematic review of overlapping meta-analyses. Medicine 2020. link 47 Li C, Qi Y, Liu G, Yin X, Jin Y, Jiang Z et al.. Long-Term Clinical Outcomes of Percutaneous Cervical Nucleoplasty for Cervical Degenerative Diseases with Neck Pain and Cervical Vertigo. World neurosurgery 2020. link 48 Hirvonen T, Siironen J, Marjamaa J, Niemelä M, Koski-Palkén A. Anterior cervical discectomy and fusion in young adults leads to favorable outcome in long-term follow-up. The spine journal : official journal of the North American Spine Society 2020. link 49 Joaquim AF, Lee NJ, Lehman RA, Tumialán LM, Riew KD. Osteolysis after cervical disc arthroplasty. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2020. link 50 Zhou J, Li J, Lin H, Li X, Dong J, Zhou X. Could self-locking stand-alone cage reduce adjacent-level ossification development after aneterior cervical discectomy and fusion?. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 2020. link 51 Zhang Y, Shao Y, Liu H, Zhang J, He F, Chen A et al.. Association between sagittal balance and adjacent segment degeneration in anterior cervical surgery: a systematic review and meta-analysis. BMC musculoskeletal disorders 2019. link 52 Lu VM, Mobbs RJ, Fang B, Phan K. Clinical outcomes of locking stand-alone cage versus anterior plate construct in two-level anterior cervical discectomy and fusion: a systematic review and meta-analysis. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2019. link 53 . Cervical Artificial Disc Replacement Versus Fusion for Cervical Degenerative Disc Disease: A Health Technology Assessment. Ontario health technology assessment series 2019. link 54 Alai NN, Skinner HB. Concurrent notalgia paresthetica and brachioradial pruritus associated with cervical degenerative disc disease. Cutis 2018. link 55 Zhu RS, Kan SL, Cao ZG, Jiang ZH, Zhang XL, Hu W. Secondary Surgery after Cervical Disc Arthroplasty versus Fusion for Cervical Degenerative Disc Disease: A Meta-analysis with Trial Sequential Analysis. Orthopaedic surgery 2018. link 56 Wang KF, Duan S, Zhu ZQ, Liu HY, Liu CJ, Xu S. Clinical and Radiologic Features of 3 Reconstructive Procedures for the Surgical Management of Patients with Bilevel Cervical Degenerative Disc Disease at a Minimum Follow-Up Period of 5 Years: A Comparative Study. World neurosurgery 2018. link 57 Badve SA, Nunley PD, Kurra S, Lavelle WF. Review of long-term outcomes of disc arthroplasty for symptomatic single level cervical degenerative disc disease. Expert review of medical devices 2018. link 58 Lu Y, Bao W, Wang Z, Zhou F, Zou J, Jiang W et al.. Comparison of the clinical effects of zero-profile anchored spacer (ROI-C) and conventional cage-plate construct for the treatment of noncontiguous bilevel of cervical degenerative disc disease (CDDD): A minimum 2-year follow-up. Medicine 2018. link 59 Wu TK, Meng Y, Wang BY, Hong Y, Rong X, Ding C et al.. Is the behavior of disc replacement adjacent to fusion affected by the location of the fused level in hybrid surgery?. The spine journal : official journal of the North American Spine Society 2018. link 60 Ning GZ, Kan SL, Zhu RS, Feng SQ. Comparison of Mobi-C Cervical Disc Arthroplasty Versus Fusion for the Treatment of Symptomatic Cervical Degenerative Disc Disease. World neurosurgery 2018. link 61 Luo J, Wang H, Peng J, Deng Z, Zhang Z, Liu S et al.. Rate of Adjacent Segment Degeneration of Cervical Disc Arthroplasty Versus Fusion Meta-Analysis of Randomized Controlled Trials. World neurosurgery 2018. link 62 Findlay C, Ayis S, Demetriades AK. Total disc replacement versus anterior cervical discectomy and fusion: a systematic review with meta-analysis of data from a total of 3160 patients across 14 randomized controlled trials with both short- and medium- to long-term outcomes. The bone & joint journal 2018. link 63 Wang LN, Hu BW, Wang L, Song YM, Yang X, Liu LM et al.. Clinical and radiographic outcome of dynamic cervical implant (DCI) arthroplasty for degenerative cervical disc disease: a minimal five-year follow-up. BMC musculoskeletal disorders 2018. link 64 Li Z, Wu H, Chu J, Liu M, Hou S, Yu S et al.. Motion analysis of dynamic cervical implant stabilization versus anterior discectomy and fusion: a retrospective analysis of 70 cases. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2018. link 65 Wu TK, Wang BY, Meng Y, Ding C, Yang Y, Lou JG et al.. Multilevel cervical disc replacement versus multilevel anterior discectomy and fusion: A meta-analysis. Medicine 2017. link 66 Narain AS, Hijji FY, Yom KH, Kudaravalli KT, Singh K. Cervical disc arthroplasty: do conflicts of interest influence the outcome of clinical studies?. The spine journal : official journal of the North American Spine Society 2017. link 67 Donk RD, Arnts H, Verhagen WIM, Groenewoud H, Verbeek A, Bartels RHMA. Cervical sagittal alignment after different anterior discectomy procedures for single-level cervical degenerative disc disease: randomized controlled trial. Acta neurochirurgica 2017. link 68 Wiedenhöfer B, Nacke J, Stephan M, Richter W, Carstens C, Eichler M. Is Total Disk Replacement a Cost-effective Treatment for Cervical Degenerative Disk Disease?. Clinical spine surgery 2017. link 69 Xu B, Ma JX, Tian JH, Ge L, Ma XL. Indirect meta-analysis comparing clinical outcomes of total cervical disc replacements with fusions for cervical degenerative disc disease. Scientific reports 2017. link 70 Bin S, Xiangwang H, Sheng X, Tiecheng X, Xiangyang L, Yi Z et al.. Artificial Cervical Disk Replacement for the Treatment of Adjacent Segment Disease After Anterior Cervical Decompression and Fusion. Clinical spine surgery 2017. link 71 Fleck SK, Langner S, Rosenstengel C, Kessler R, Matthes M, Müller JU et al.. 3-Tesla Kinematic MRI of the Cervical Spine for Evaluation of Adjacent Level Disease After Monosegmental Anterior Cervical Discectomy and Arthroplasty: Results of 2-Year Follow-Up. Spine 2017. link 72 Li Z, Zhao Y, Tang J, Ren D, Guo J, Wang H et al.. A comparison of a new zero-profile, stand-alone Fidji cervical cage and anterior cervical plate for single and multilevel ACDF: a minimum 2-year follow-up study. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2017. link 73 MacDowall A, Robinson Y, Skeppholm M, Olerud C. Anxiety and depression affect pain drawings in cervical degenerative disc disease. Upsala journal of medical sciences 2017. link 74 Nambiar M, Phan K, Cunningham JE, Yang Y, Turner PL, Mobbs R. Locking stand-alone cages versus anterior plate constructs in single-level fusion for degenerative cervical disease: a systematic review and meta-analysis. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2017. link 75 Wu TK, Wang BY, Cheng D, Rong X, Lou JG, Hong Y et al.. Clinical and radiographic features of hybrid surgery for the treatment of skip-level cervical degenerative disc disease: A minimum 24-month follow-up. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 2017. link 76 Boselie TFM, van Santbrink H, de Bie RA, van Mameren H. Pilot Study of Sequence of Segmental Contributions in the Lower Cervical Spine During Active Extension and Flexion: Healthy Controls Versus Cervical Degenerative Disc Disease Patients. Spine 2017. link 77 Zhao J, Jiang R, Yang Y, Gu R, Gao Z, Xiao J et al.. Preoperative T1 Slope as a Predictor of Change in Cervical Alignment and Range of Motion After Cervical Disc Arthroplasty. Medical science monitor : international medical journal of experimental and clinical research 2017. link 78 Burkhardt BW, Brielmaier M, Schwerdtfeger K, Sharif S, Oertel JM. Smith-Robinson Procedure with an Autologous Iliac Crest for Degenerative Cervical Disc Disease: A 28-Year Follow-Up of 95 Patients. World neurosurgery 2016. link 79 Chotai S, Sielatycki JA, Parker SL, Sivaganesan A, Kay HL, Stonko DP et al.. Effect of obesity on cost per quality-adjusted life years gained following anterior cervical discectomy and fusion in elective degenerative pathology. The spine journal : official journal of the North American Spine Society 2016. link 80 Ahn SS, Paik HK, Chin DK, Kim SH, Kim DW, Ku MG. The Fate of Adjacent Segments After Anterior Cervical Discectomy and Fusion: The Influence of an Anterior Plate System. World neurosurgery 2016. link 81 Zhao Y, Zhang Y, Sun Y, Pan S, Zhou F, Liu Z. Application of Cervical Arthroplasty With Bryan Cervical Disc: 10-Year Follow-up Results in China. Spine 2016. link 82 Shi S, Liu ZD, You WJ, Ouyang YP, Li XF, Qian L et al.. Application of a stand-alone anchored spacer in noncontiguous anterior cervical arthrodesis with radiologic analysis of the intermediate segment. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 2016. link 83 El-Tantawy A. Is it possible to eliminate the plate-related problems and still achieve satisfactory outcome after multilevel anterior cervical discectomy?. European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 2015. link 84 Luo J, Gong M, Huang S, Yu T, Zou X. Incidence of adjacent segment degeneration in cervical disc arthroplasty versus anterior cervical decompression and fusion meta-analysis of prospective studies. Archives of orthopaedic and trauma surgery 2015. link 85 Matgé G, Buddenberg P, Eif M, Schenke H, Herdmann J. Dynamic cervical stabilization: a multicenter study. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2015. link 86 Janssen ME, Zigler JE, Spivak JM, Delamarter RB, Darden BV, Kopjar B. ProDisc-C Total Disc Replacement Versus Anterior Cervical Discectomy and Fusion for Single-Level Symptomatic Cervical Disc Disease: Seven-Year Follow-up of the Prospective Randomized U.S. Food and Drug Administration Investigational Device Exemption Study. The Journal of bone and joint surgery. American volume 2015. link 87 Wang Z, Jiang W, Li X, Wang H, Shi J, Chen J et al.. The application of zero-profile anchored spacer in anterior cervical discectomy and fusion. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2015. link 88 Marbacher S, Hidalgo-Staub T, Kienzler J, Wüergler-Hauri C, Landolt H, Fandino J. Long-term outcome after adjacent two-level anterior cervical discectomy and fusion using stand-alone plasmaphore-covered titanium cages. Journal of neurological surgery. Part A, Central European neurosurgery 2015. link 89 Gao F, Mao T, Sun W, Guo W, Wang Y, Li Z et al.. An Updated Meta-Analysis Comparing Artificial Cervical Disc Arthroplasty (CDA) Versus Anterior Cervical Discectomy and Fusion (ACDF) for the Treatment of Cervical Degenerative Disc Disease (CDDD). Spine 2015. link 90 Klingler JH, Krüger MT, Sircar R, Kogias E, Scholz C, Volz F et al.. PEEK cages versus PMMA spacers in anterior cervical discectomy: comparison of fusion, subsidence, sagittal alignment, and clinical outcome with a minimum 1-year follow-up. TheScientificWorldJournal 2014. link 91 Zhang Z, Zhu W, Zhu L, Du Y. Midterm outcomes of total cervical total disc replacement with Bryan prosthesis. European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 2014. link 92 Wang L, Song YM, Liu LM, Liu H, Li T. Clinical and radiographic outcomes of dynamic cervical implant replacement for treatment of single-level degenerative cervical disc disease: a 24-month follow-up. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2014. link 93 Yang H, Lu X, Yuan W, Wang X, Chen D, Zhao D. Artificial disk replacement in the treatment of degenerative cervical disk disorder: a 30-year follow-up study. Spine 2014. link 94 Jang JW, Lee JK, Lee JH, Hur H, Kim TW, Kim SH. Effect of posterior subsidence on cervical alignment after anterior cervical corpectomy and reconstruction using titanium mesh cages in degenerative cervical disease. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 2014. link 95 Miao J, Yu F, Shen Y, He N, Kuang Y, Wang X et al.. Clinical and radiographic outcomes of cervical disc replacement with a new prosthesis. The spine journal : official journal of the North American Spine Society 2014. link 96 Qureshi S, Goz V, McAnany S, Cho SK, Hecht AC, Delamarter RB et al.. Health state utility of patients with single-level cervical degenerative disc disease: comparison of anterior cervical discectomy and fusion with cervical disc arthroplasty. Journal of neurosurgery. Spine 2014. link 97 Alvin MD, Qureshi S, Klineberg E, Riew KD, Fischer DJ, Norvell DC et al.. Cervical degenerative disease: systematic review of economic analyses. Spine 2014. link 98 Song KJ, Song JS, Kim DY, Shim DG, Lee KB. Efficacy of combined anteroposterior fusion with no plate versus anterior fusion alone with cage and plate for multilevel degenerative cervical disease. The spine journal : official journal of the North American Spine Society 2014. link 99 Wu WJ, Jiang LS, Liang Y, Dai LY. Cage subsidence does not, but cervical lordosis improvement does affect the long-term results of anterior cervical fusion with stand-alone cage for degenerative cervical disc disease: a retrospective study. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2012. link 100 McGuire KJ, Harrast J, Herkowitz H, Weinstein JN. Geographic variation in the surgical treatment of degenerative cervical disc disease: American Board of Orthopedic Surgery Quality Improvement Initiative; part II candidates. Spine 2012. link

Original source

[1]
Contemporary decision-making factors leading to cervical disc replacement versus fusion for the treatment of single-level degenerative cervical radiculopathy or myelopathy: survey opinions from members of the society of minimally invasive spine surgeon and cervical spine research society. — Shafi KA, Lui ATH, Mikhail C, Morse K, Zhang J, Kwas C et al. The spine journal : official journal of the North American Spine Society (2026)
[2]
Cage only or cage with plate fixation in anterior cervical discectomy and fusion surgery - analysis of a national multicenter dataset. — Gerdhem L, Vlachogiannis P, Gerdhem P, MacDowall A The spine journal : official journal of the North American Spine Society (2025)
[3]
Anterior bone loss after anterior cervical discectomy and fusion: influence factors and its impact on surgical outcomes. — Zong R, Liu CY, Jin YZ, Peng ZH, He JB, Wu TK et al. BMC musculoskeletal disorders (2025)
[4]
Is screw position a greater contributor to adjacent segment disease than plate-to-disc distance following anterior cervical discectomy and fusion? — Wang F, Lu J, Wang B, Zhu Z, Shen B, Guo K et al. BMC musculoskeletal disorders (2025)
[5]
Comparison of cervical disc arthroplasty versus anterior cervical discectomy and fusion for the treatment of single-segment cervical degenerative disc disease with a minimum of 4-year follow-up: a systematic review and meta-analysis of randomized controlled trials. — Zhang Y, Ju J, Wu J Journal of orthopaedic surgery and research (2025)
[6]
Efficacy and safety of ROI-C™ self-locking system versus cage combined with screw-plate internal fixation in the treatment of degenerative cervical disease: A meta-analysis. — Xu X, Guo X, Zhou Q, Song Z Medicine (2025)
[7]
Zero-profile devices versus traditional cage-plate systems for geriatric osteoporotic patients with cervical degenerative disc disease: a retrospective analysis of 190 patients. — Guo Y, Xie Q, Xu Q, Li D, Wang A, Liu Y et al. European journal of medical research (2025)
[8]
Facet Distraction Distance Independently Predicts Cage Subsidence Following Anterior Cervical Discectomy and Fusion. — Zhao C, Wang S, Zhang J, Niu H, Cao Y, Shen C et al. World neurosurgery (2025)
[9]
A Strong Association Between Modic Changes Type 2 and Endplate Defects at Nonfused Segments After Anterior Cervical Decompression and Fusion. — Leonova O, Baykov E, Krutko A World neurosurgery (2025)
[10]
The Influence of Zero-Profile Implant Selection on the Outcomes of Anterior Cervical Discectomy and Fusion. — Wang XJ, He JB, Wu TK, Wang BY, Rong X, Gong Q et al. Orthopaedic surgery (2025)
[11]
Does two-level hybrid surgery promote early fusion compared with two-level anterior cervical discectomy and fusion? — Li J, Wu Y, Liu H, Guo C, Zhang J, Huang K et al. The spine journal : official journal of the North American Spine Society (2025)
[12]
Biomechanical analysis of single and multi-level artificial disc replacement (ADR) in cervical spine using multi-scale loadings: A finite element study. — Kumar R, Kumar A, Kumari S The International journal of artificial organs (2024)
[13]
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