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Supplemental Digital Content is available in the text, Background: In the current surgical therapeutic regimen for symptomatic cervical degenerative disc disease, both anterior cervical discectomy and fusion (ACDF) and anterior cervical disc replacement (ACDR) are still widely accepted. However, many complications exist in both surgeries. Therefore, this study aims to compare the adverse events between ACDR and ACDF, and provide vital evidence-based guidance for spine surgeons and designers to evaluation of prognosis and improvement of dynamic devices. Methods: A systematic review and meta-analysis that will be performed according to the PRISMA. The electric database of PubMed, Medline, Embase, Google Scholar, and Cochrane library will be systematic search. A standard data form will be used to extract the data of included studies. We will assess the studies according to the Cochrane Handbook for Systematic Reviews of Interventions, and perform analysis in RevMan 5.3 software. Fixed effects models will be used for homogeneity data, while random-effects will be used for heterogeneity data. The overall effect sizes will be determined as weighted mean difference (WMD) for continuous outcomes and relative risk (RR) for dichotomous outcomes. Result: The results of this study will be disseminated via international or national conferences, or submit to peer-reviewed journal in spinal field. Conclusion: The conclusion of this study will provide key evidence-based guidance for spine surgeons and designers to the evaluation of prognosis and improvement of dynamic devices.

Supplemental Digital Content is available in the text, Background: Nowadays, anterior cervical artificial disc replacement (ACDR) has achieved favorable outcomes in treatment for patients with single-level cervical spondylosis. However, It is still controversial that whether or not it will become a potent therapeutic alternation in treating 2 contiguous levels cervical spondylosis compared with anterior cervical decompression and fusion (ACDF). Therefore, we conducted a systematic review and meta-analysis to compare the efficacy and safety of ACDR and ACDF in patients with 2 contiguous levels cervical spondylosis. Methods: According to the computer-based online search, PubMed, Embase, Web of Science, and Cochrane Library for articles published before July 1, 2017 were searched. The following outcome measures were extracted: neck disability index (NDI), visual analog scale (VAS) neck, VAS arm, Short Form (SF)-12 mental component summary (MCS), SF-12 physical component summary (PCS), overall clinical success (OCS), patient satisfaction (PS), device-related adverse event (DRAE), subsequent surgical intervention (SSI), neurological deterioration (ND), and adjacent segment degeneration (ASD). Methodological quality was evaluated independently by 2 reviewers using the Furlan for randomized controlled trial (RCT) and MINORS scale for clinical controlled trials (CCT). The chi-squared test and Higgin I2 test were used to evaluate the heterogeneity. A P