One level arthroplasty has been shown to be a safe alternative to one level anterior cervical diskectomy and fusion in selected patients with similarly excellent outcome. It has an added potential benefit of reducing the adjacent segment degeneration. Multi-level cervical arthroplasty has not yet been widely used in the United States due to the lack of long term data. In the June 2015 issue of Spine, Bae et al. reported their 4-year data from a randomized controlled IDE trial. In the study, 164 patients received Mobi-C disc at one cervical level and 225 patients at two contiguous levels. Both group reported similarly excellent improvement and maintenance of the improvement in NDI score, VAS neck and arm pain score, SF-12 score and overall patient satisfaction during the four year follow up period. Both groups reported similarly low complication rates. The rate of radiographic adjacent segment pathology and heterotopic ossification are similar between the two groups as well.