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Purpose Toevaluatetheincidenceofadjacentsegmentdisease(ASD)requiringsurgicalinterventionbetween anteriorcervicaldecompressionandfusion(ACDF)andtotaldiscreplacement(TDR).BackgroundTheconcernforASDhasledtothedevelopmentofmotion-preservingtechnologiessuchas TDR.However,whetherreplacementarthoplastyinthespineachievesitsprimarypatientcenteredobjectiveof loweringthefrequencyofadjacentsegmentdegenerationisnotverifiedyet.