Cervical disc replacement is a safe option across all obesity levels compared to anterior cervical discectomy and fusion, according to a study in the April 2025 issue of The Spine Journal.
Researchers used data from PearlDiver to identify a total 12,545 cervical disc replacement patients and 45,513 ACDF patients between 2011 and 2020. They were stratified by BMI and defined as healthy weight, overweight, obese and morbidly obese.
A comparative analysis found that after 90 days post-surgery, medical complications, including infection, wound dehiscence, and readmissions, were comparable across all patients. After two years anterior revision was higher in healthy weight patients.
Across all obese patients, there were higher 90-day emergency room visits and one-year hardware removal in ACDF patients compared to disc replacement patients.
The study concluded that “CDA may be safe across varying levels of obesity without any appreciable change in medical and surgical complications. In addition, single-level ACDF may result in higher complications than single-level CDA in the obese population.”
