An appreciation of the frequency with which cervical fusion accelerates adjacent disc disease has led to the development of mobile artificial disc prostheses. At least six models are well advanced in clinical trials. Initial results show that such discs are as effective as current surgical techniques involving fusion, that they have few complications and that they preserve the range of movement of the relevant intervertebral joint. The question as to whether they will endure and prevent accelerated disc disease will only be answered by very long-term studies (10-20 years). Meanwhile, the results are encouraging and cervical arthroplasty may well be indicated in the majority of cervical disc problems requiring surgery, provided they are not associated with other local spinal disease or instability. (c) 2005 Elsevier Ltd. All rights reserved.