Two-Level Cervical Disc Replacement

Cervical disc replacement is a surgical procedure that relieves chronic pain from pressure placed on nerves in the neck (cervical spine).

The procedure involves removing the offending disc and placing an artificial disc device in its place. In a 2-level cervical artificial disc replacement, not one but 2 adjacent problematic discs are removed and replaced with two artificial disc devices.

See Surgical Procedure for Cervical Disc Replacement

It is designed to address chronic pain from pressure placed on nerves in the neck (cervical spine). As a general rule, the 2-level cervical artificial disc surgery is considered for all the same indications as a 1-level disc replacement: it may be considered to treat pathological disc disease at 2 adjacent levels of the cervical spine, such as herniated discs and/or degeneration that has led to formation of bone spurs (osteophytes) that are impinging on the spinal cord and/or nerve roots.

Artificial cervical disc replacement is starting to gain popularity with younger and more active patients as it allows for shorter recovery times over other surgical options like fusion.

At the time of this article, one product has been approved for treatment of 2-level cervical disc replacement in the United States, the Mobi-C.¹Mobi-C® Cervical Disc Prosthesis – P110002. FDA: U.S. Food and Drug Administration. 13 January 2015 . Available at http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm366047.htm. Several devices are FDA-approved only for single-level use.

Clinical Trial Results

In the clinical trial, 2-level Mobi-C disc replacement demonstrated superiority in overall trial success compared to 2-level ACDF, which is considered the standard surgical option for treating 2-level cervical disc disease. Mobi-C was deemed to have demonstrated superiority over ACDF at 2 years follow-up.²Two-Level Disc Replacement Reduces Reoperation vs Fusion. Medscape. Oct 21, 2013.

See ACDF: Anterior Cervical Discectomy and Fusion

In the trial, two main differences between the 2-level cervical artificial disc and ACDF included²Two-Level Disc Replacement Reduces Reoperation vs Fusion. Medscape. Oct 21, 2013.

• 3 percent of patients receiving the artificial disc needed a second surgery versus about 11 percent of patients who had the 2-level ACDF
• For the artificial disc patients, the mean time to return to work was about 46 days, versus about 67 days for ACDF, indicating a faster recovery time

The Mobi-C is currently indicated for use in the cervical spine between the C3 - C7 levels for both 1- and 2-level disease.