For a study, the researchers wanted to determine how patient-reported outcome measures (PROMs) and patient satisfaction compared with multilevel lumbar total disc arthroplasty (TDA) for symptomatic multilevel degenerative disc disease (MLDDD).  TDA had been found to be both safe and effective in the treatment of single-level degenerative disc degeneration. On the mid to long-term consequences of multilevel TDA constructs, there was very little PROMs evidence. Patients getting multilevel TDA for symptomatic MLDDD had their PROMs gathered prospectively and assessed. Preoperative and postoperative data were obtained at 3, 6, and 12 months, then yearly. Patient satisfaction, the Visual Analog Score back and leg, the Oswestry Disability Index, and the Roland-Morris Disability Questionnaire were among the PROMs. A total of 122 patients (77 men and 45 women) with preoperative and at least 24-month follow-up data were included in the study. The mean follow-up was 7.8 years (range 2–10) and the average age was somewhere between 33.8 to 50.2 years (range 21–61). Except for two patients (1.6%) who had three-level TDA, the majority of patients received two-level TDA. The two- to three-level TDAs were at levels L3–4, L4–5, and L5–S1, with the majority (n=110, 90.2%) at L4–5 and L5-S1 and the rest (n=10, 8.2%) at L3–4 and L4–5. Charité (DePuy Spine, Raynham, MA) implants were used in 119 patients (240 levels) and InMotion (DePuy Spine) implants in three patients (6 levels). The improvement in pain and disability scores was clinically and statistically substantial (P<0.001), and it was maintained in those patients during their follow-up. At the end of the study, 92% of patients said they were satisfied with their treatment.  At mid-to-long-term follow-up, multilevel TDA frameworks for MLDDD show good and persistent clinical outcomes.