Authors
Darius Ansari, Garret P Greeneway, Niall A Buckley, Nathaniel P Brooks, Bradley T Schmidt, Gregory R Trost, Daniel K Resnick
Published in
Neurosurgical focus. Volume 61. Issue 1. Pages E2. Jul 01, 2026.
Abstract
Cervical disc arthroplasty (CDA) has emerged as a motion-preserving treatment for symptomatic cervical disc disease refractory to nonoperative management in carefully selected patients. Given the interest in expanding on-label uses to include procedures such as hybrid arthroplasty-fusion constructs and 3- and 4-level arthroplasty, authors of this study sought to define the contemporary prevalence of absolute and relative contraindications to cervical arthroplasty.
The authors conducted a retrospective observational cross-sectional study of all patients in whom > 6 weeks of nonoperative management had failed and who subsequently underwent cervical spine surgery at a single academic institution between January 1, 2022, and September 1, 2024. They reviewed the US Food and Drug Administration investigational device exemption studies of several cervical arthroplasty devices for their listed contraindications. Trauma, infection, malignancy, and deformity cases were excluded from analysis, as were cases with < 3 months of clinical follow-up. For each patient, preoperative cervical spine imaging and clinical data were reviewed and assessed for the presence of each contraindication, type of surgical procedure performed, and proportion of cases that would have been candidates for CDA had each contraindication been relaxed.
A total of 334 cases were reviewed. Of these, 268 (80.2%) had at least 1 contraindication to CDA, and 66 (19.8%) were eligible for the procedure. The most common contraindications were severe spondylosis, disc height loss, facet degeneration, > 2 operative levels, and adjacent fusion. Only 24 (36.4%) of the 66 eligible patients underwent CDA, and the remainder underwent posterior foraminotomy (37.9%), anterior cervical discectomy and fusion (21.2%), or laminectomy/laminoplasty (4.5%).
In this contemporary analysis of an academic practice, 19.8% of operative cervical spine degeneration cases met the criteria for CDA. Further studies suggesting expansions or changes to the indications for CDA must pay careful attention to the patient population being evaluated.
PMID:
42385250
Bibliographic data and abstract were imported from PubMed on 02 Jul 2026.
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