Comparison of sagittal parameters for anterior cervical discectomy and fusion, hybrid surgery, and total disc replacement for three levels of cervical spondylosis

Hung, Che-Wei; Wu, Ming-Fang; Yu, Gwo-Fane; Ko, Chin-Chu; Kao, Cheng-Hsing

doi:10.1016/j.clineuro.2018.03.003

Cited by 14 publications

(20 citation statements)

References 19 publications

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“…Our data showed that during all functional neck motions, C7-T1 allows the smallest ROMs, indicating that C7-T1 could be more suitable for the fusion treatment; the segments above C7-T1 may favor TDR treatments. Recently, hybrid surgery has been thought to be a promising solution to multisegment cervical diseases (Grasso, 2015;Hung et al, 2018;Zang et al, 2015). Clinical studies generally suggested that hybrid surgeries, in which the fusions were commonly performed near C7-T1, can be comparable with and even superior to multi-segment fusions or TDRs (Grasso, 2015;Hung et al, 2018;Zang et al, 2015), consistent with the implication of this study.…”

Section: Discussionsupporting

confidence: 86%

Intervertebral range of motion characteristics of normal cervical spinal segments (C0-T1) during in vivo neck motions

Zhou

Wang

et al. 2020

Journal of Biomechanics

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The in vivo intervertebral range of motion (ROM) is an important predictor for spinal disorders.While the subaxial cervical spine has been extensively studied, the motion characteristics of the occipito-atlantal (C0-1) and atlanto-axial (C1-2) cervical segments were less reported due to technical difficulties in accurate imaging of these two segments. In this study, we investigated the intervertebral ROMs of the entire cervical spine (C0-T1) during in vivo functional neck motions of asymptomatic human subjects, including maximal flexion-extension, left-right lateral bending, and left-right axial torsion, using previously validated dual fluoroscopic imaging and model registration techniques. During all neck motions, C0-1, similar to C7-T1, was substantially less mobile than other segments and always contributed less than 10% of the cervical rotations. During the axial rotation of the neck, C1-2 contributed 73.2±17.3% of the cervical rotation, but each of other segments contributed less than 10% of the cervical rotation. During both lateral bending and axial torsion neck motions, regardless of primary or coupled motions, the axial torsion ROM of C1-2 was significantly greater than its lateral bending ROM (p<0.001), whereas the opposite *

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Section: Discussionsupporting

confidence: 86%

Intervertebral range of motion characteristics of normal cervical spinal segments (C0-T1) during in vivo neck motions

Zhou

Wang

et al. 2020

Journal of Biomechanics

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“…For three-level CDDD, the safety and efficacy of HS were compared with those of ACDF in many studies [ 22 – 25 ]. The clinical outcomes were satisfactory, and the ROM of the cervical spine seemed to be preserved.…”

Section: Discussionmentioning

confidence: 99%

Classification of three-level hybrid surgery for the treatment of cervical degenerative disc disease: a retrospective study of 108 patients

et al. 2022

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Introduction According to the different numbers and locations of cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF), three-level hybrid surgery (HS) has many constructs. The purpose of the present study was to introduce a classification system for three-level HS and compare the two types with each other and with ACDF. Methods A retrospective study was conducted involving patients with three-level cervical degenerative disc disease (CDDD) who underwent ACDF or HS in our hospital between June 2012 and May 2019. According to the different numbers and locations of ACDFs and CDAs, we classified the three-level HS into two types (type I: one-level CDA and two-level ACDF, and type II: two-level CDA and one-level ACDF). The differences of clinical and radiological outcomes were compared with each other and with three-level ACDF. Results A total of 108 patients were analyzed. The Neck Disability Index (NDI) of the ACDF group at 3 months postoperatively was significantly higher than that in the type I and type II groups (p < 0.05). The cervical lordosis was significantly lower in the ACDF group than that in the type I and II groups at 3 days, 6, 12 months postoperatively and the final follow-up (p < 0.05). The range of motion (ROM) of the total cervical spine decreased significantly in all three groups at 3, 6, and 12 months postoperatively and at the final follow-up (p < 0.05). The ACDF group was observed with the most severe loss of ROM of the total cervical spine, followed by the type I group. The type II group could preserve the most ROM of the total cervical spine. The ROM of adjacent segments increased most in the ACDF group, followed by the type I group. Conclusions Compared with ACDF, three-level HS may yield a faster recovery rate and superior radiological outcomes, such as a superiority in maintaining the cervical curvature and ROM of the total cervical spine and a smaller increase in the ROM of adjacent segments. The advantages were most remarkable in the type II group.

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“…Previous studies have demonstrated that HS is a safe, effective, and reliable surgical procedure for multilevel CDDD. [1][2][3] In HS, CDA was performed at the mobile level, and ACDF was performed at the spondylotic level. Due to the different locations and numbers of CDAs, HS has different constructs.…”

Section: Introductionmentioning

confidence: 99%

“…Hybrid surgery (HS), consisting of cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) has been used for multilevel cervical degenerative disc disease (CDDD). Previous studies have demonstrated that HS is a safe, effective, and reliable surgical procedure for multilevel CDDD 1–3 . In HS, CDA was performed at the mobile level, and ACDF was performed at the spondylotic level.…”

Section: Introductionmentioning

confidence: 99%

Cervical disc arthroplasty combined with two‐level ACDF for the treatment of contiguous three‐level cervical degenerative disc disease: A comparative study

Huang

Liu

Wang

et al. 2022

Journal Orthopaedic Research

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To compare the differences among constructs with one‐level cervical disc arthroplasty (CDA) and two‐level anterior cervical discectomy and fusion (ACDF). A retrospective study was conducted involving patients who underwent one‐level CDA and two‐level ACDF between June 2012 and July 2020. According to the different locations of CDA and ACDF, we divided the constructs into three types: type Ⅰa: CDA‐ACDF‐ACDF; type Ⅰb: ACDF‐CDA‐ACDF; type Ⅰc: ACDF‐ACDF‐CDA. The differences of clinical and radiological outcomes were evaluated. Fifty‐three patients were included with 29 in type Ⅰa group, 11 in type Ⅰb group, and 13 in type Ⅰc group. After surgery, all groups showed significant improvement in apanese Orthopedic Association, Neck Disability Index, and Visual Analog Scale scores (p < 0.001). Range of motion (ROM) of the total cervical spine in type Ⅰc group decreased significantly compared with those in type Ⅰa and type Ⅰb groups (p < 0.05). No significant differences in ROM of the arthroplasty segment and the variations in ROM of the superior adjacent segment were observed among the three groups. The fusion rates of the superior ACDF segments were significantly higher at 6 and 12 months postoperatively than those of the inferior ACDF segments (p < 0.05). The clinical outcomes were similar among constructs concerning different locations of CDA and ACDF in three‐level hybrid surgery. ROM of the cervical spine in type Ⅰc group decreased significantly compared with that in type Ⅰa and type Ⅰb groups. The fusion rates of superior ACDF segments were higher at early time points after surgery than those of inferior ACDF segments.

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Comparison of sagittal parameters for anterior cervical discectomy and fusion, hybrid surgery, and total disc replacement for three levels of cervical spondylosis

Cited by 14 publications

References 19 publications

Intervertebral range of motion characteristics of normal cervical spinal segments (C0-T1) during in vivo neck motions

Intervertebral range of motion characteristics of normal cervical spinal segments (C0-T1) during in vivo neck motions

Classification of three-level hybrid surgery for the treatment of cervical degenerative disc disease: a retrospective study of 108 patients

Cervical disc arthroplasty combined with two‐level ACDF for the treatment of contiguous three‐level cervical degenerative disc disease: A comparative study

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