Comparison of 2-Level Cervical Artificial Disc vs. 2 Level ACDF

While neither of these procedures is perfect, each approach has relative potential benefits and risks.

See Outpatient Anterior Cervical Discectomy and Fusion (ACDF)

The additional range of motion provided by an artificial surgical disc is thought to potentially decrease the incidence of degeneration at adjacent levels. Learn more: Artificial Disc Vs. Anterior Cervical Discectomy and Fusion

For example:

Potential advantages of cervical artificial disc replacement:


Potential benefits versus 2-level ACDF:

Spinal fusions have been performed in the United States since as early as the 1950s, while disc replacement technologies have only been around since they were first approved by the FDA in the mid-2000s. Two-level cervical artificial discs have been approved for use for an even shorter period of time, and presently published data are only available for 2-year follow-up, although longer-term results are being tabulated. As such, longer-term risks and potential complications are less well known relative to ACDF.1 For some patients and surgeons, the most substantial potential future risk is if the disc implant would need to be removed at some point in the future. Since many people who are candidates for this procedure are relatively young, this is a significant consideration.

See Multilevel Fusion Risks

A second potential risk of cervical disc replacement is that the implant used may at some point suffer a mechanical failure or breakage; this is a risk for any newer type of implant and is not unique to the disc prosthesis per se.

See Indications for Two-Level Spinal Fusion


More data on disc replacement is being generated every year, and longer-term outcomes are being carefully tracked under FDA monitoring, but both patients and physicians must understand that this is a newer surgical option without longer term experience. Reoperation rates after cervical disc replacement are generally less than after fusion surgery. Revision of a failed artificial disc implant to a fusion, although unlikely, is usually possible.


  • 1.Kepler CK, Brodt ED, Dettori JR, Albert TJ. Cervical artificial disc replacement versus fusion in the cervical spine: a systematic review comparing multilevel versus single-level surgery. Evid Based Spine Care J. 2012;3(S1):19-30.