Foraminotomies can be performed at any level in the cervical spine as long as the indications are correct ands there are no contra-indications (degenerative spondylolisthesis, central disc herniation, bone spur originating from anterior uncovertebral joint). The procedure is performed for nerve compression (arm pain) and not for neck pain.
After a single level ACDF, my patients can go back to the NFL. Even with a three level ACDF, patients can go back to golf. Two levels are the maximum if they are professional golfers. Artificial disc replacement allows more levels to be surgically involved.