The Argument for Anterior Cervical Diskectomy and Fusion Over Total Disk Replacement

Anterior cervical diskectomy and fusion is one of the most commonly performed cervical spine procedures with historically excellent results. In an effort to preserve segmental motion and prevent adjacent segment degeneration, cervical total disk replacement was developed. Although the short-term data show comparable results, its superiority to ACDF remains controversial. This manuscript will highlight the literature that has supported ACDF as a treatment option for single level cervical pathology. In addition, we will review adjacent segment disease, its natural history, and what to expect as we begin to see the long-term results from total disk replacement.