Reoperation rates between cervical disc replacement and anterior cervical discectomy and fusion didn’t see significant differences in reoperation risks. However disc replacement had some advantage in lowering adjacent segment disease-related reoperations, according to a study in the Feb. 1, 2026 issue of Spine.
Five things to know:
1. Researchers used data from a national spine registry to identify adult patients (18 to 60 years old) with cervical degenerative disc disease who had a one- or two-level disc replacement or ACDF.
2. The cohort of 6,318 patients had a mean follow-up of 6.9 years. Propensity score matching yielded 809 disc replacement patients and 2,427 ACDF patients.
3. There was a lower risk of reoperation for adjacent segment disease in patients who had disc replacement compared with ACDF. However the difference wasn’t statistically significant.
4. There was no difference in all-cause reoperation risks between the procedures. The mean time to an ASD reoperation was 3.9 years for disc replacement and 4.4 years for ACDF.
5. The study concluded, “With nearly seven years of average follow-up, this large registry-based study showed that one-level CDA did not significantly reduce the risk of ASD or all-cause reoperations compared with ACDF. Similar results were only seen for all-cause reoperations in two-level CDA. Importantly, ASD reoperations occurred within four to five years on average, underscoring that while CDA preserves motion, the risk of subsequent surgery remains. These findings highlight the real-world performance of CDA and may reflect other factors that increase all-cause reoperations, which may have been underreported.”
