32 studies, (randomized trials and prospective cohorts) reporting adjacent segment degeneration and disease rates in patients who underwent cervical arthroplasty were included in this systematic review and meta-analysis. The purpose of this study was to assess the incidence of adjacent segment pathology following cervical arthroplasty. The incidence of adjacent segment degeneration was 8.3% and the incidence of adjacent segment disease was 0.9%. The incidence of degeneration and disease were greater in studies with long-term follow-up (greater than 24 months). No differences were noted in the rates of degeneration of the superior or inferior level of the operated disc.