Anterior Hybrid Construction of Multilevel Cervical Disc Disease and Spondylotic Spinal Stenosis: Surgical Results and Factors Affecting Adjacent Segment Problems

Abstract

Objective: We aimed to evaluate reliability, radiological outcomes and the impacts of anterior cervical hybrid construction on the adjacent segments for the multilevel cervical degenerative disc disease (mCDDD) and spondylotic spinal stenosis (SSS).Methods: A retrospective analysis was performed using data extracted from the medical files of 195 patients (105 males, 90 females; mean age: 47.7 years). From 2008 to 2018, these patients underwent anterior cervical hybrid construction for symptomatic contiguous at least 2-level cervical degenerative disc diseases and cervical spondylosis. Clinical and radiological data including Neck Disability Index (NDI), Visual Analogue Scale (VAS), local cervical degenerative disk disease in adjacent segments on magnetic resonance imaging (MRI) views and complications were reviewed. Results: The mean clinical and radiological follow-up was 45.2 months (range: 24 to 102). Radiculopathy and/or myelopathy were the main clinical problems in all patients. The mean VAS scores of HC for arm pain were 7.4±0.8 preoperatively; 2.8±0.6, 1 month after surgery; 2.3±0.6, 6 months after surgery; 1.8±0.6, 12 month after surgery; and 1.6±0.6, 24 months after surgery. The mean NDI scores (mean±SD) of HC significantly improved after surgery (on admission, 57.2±5.5%; 1 month after surgery, 27.35±5.3%; 6 month after surgery, 21.43±2.8%; 12 months after surgery, 21.9±2.3%; 24 months after surgery, 20.6±2.6%, p=0.006). Hoarseness and dysphagia were the most common complications and osteophyte formation was the most frequent radiographic change.Conclusion: Anterior cervical hybrid construction appears to be an acceptable option in the management of multilevel cervical degenerative disc diseases and spondylotic spinal stenosis.

Efficacy of Posterior Cervical Laminectomy and Decompression plus Lateral Mass Screw-Rod Internal Fixation in the Treatment of Multisegment Cervical Spinal Canal Stenosis and Effects on Cervical Curvature and Range of Motion Parameters

“…Cervical spondylotic myelopathy is a common and frequently occurring disease in orthopedics clinics, and cervical spinal stenosis is one of the important pathological bases of cervical spondylotic myelopathy [1,2]. Multisegment cervical spinal canal stenosis is a severe cervical degenerative disease, which is mainly caused by factors such as ossification of the posterior longitudinal ligament of the cervical spine, multisegment cervical disc herniation, hypertrophy of ligamentum flavum, hyperplasia of articular processes, and developmental cervical spinal canal stenosis, thus causing blood circulation disorders of the spinal cord, compression of nerve roots and spinal cord, and finally the corresponding nerve root and spinal cord symptoms [3,4].…”