Is hybrid surgery of the cervical spine a good balance between fusion and arthroplasty? Pilot results from a single surgeon series

Hey, Hwee Weng Dennis; Hong, Choon Chiet; Long, Ai Sha; Hee, Hwan Tak

doi:10.1007/s00586-012-2486-6

Cited by 60 publications

(49 citation statements)

References 25 publications

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“…36,39,40 Similar results between single-level and multilevel arthroplasty groups have been found in terms of reoperation rates and serious adverse events. 3 The existing literature compares either ACDF with HS or ADR with HS. 25,35,42 By combining ACDF and ADR in HS, the main objective is to restore or maintain motion where appropriate, or to favor bony fusion when indicated by the extent of the degenerative changes and hypermobility.…”

Section: Discussionmentioning

confidence: 99%

“…41 Moreover, several studies have shown that the duration of operation for ADR is much greater than for ACDF. 3,4,37,38 Although some long-term follow-up (at least 4 y) studies exist that suggest C-ADR is a safe option, [33][34][35] only a few article have considered the outcomes of HS, and these have had a maximum follow-up of 2 years. 6,10 Theoretically, HS should be intermediate between both ACDF and ADR in terms of intraoperative and postoperative results.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11][12] HS consists of cervical artificial disk replacement (C-ADR) at the mobile level and ACDF at the spondylotic level. [1][2][3][4][5][6][7][8][9][10][11][12] HS consists of cervical artificial disk replacement (C-ADR) at the mobile level and ACDF at the spondylotic level.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Artificial Disk Replacement Combined With Fusion Versus 2-Level Fusion in Cervical 2-Level Disk Disease With a 5-Year Follow-up

Oh²,

Shin³

et al. 2017

Clinical Spine Surgery: A Spine Publication

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Artificial Disk Replacement Combined With Fusion Versus 2-Level Fusion in Cervical 2-Level Disk Disease With a 5-Year Follow-up

Oh²,

Shin³

et al. 2017

Clinical Spine Surgery: A Spine Publication

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show abstract

“…Because not all diseased levels may meet acceptable criteria for CDA, some authors turned to hybrid surgery as an alternative to multilevel ACDF or CDA. Hey et al 12 conducted a prospective study with a minimum 2-year follow-up and found that hybrid surgery incorporating ACDF and CDA is comparable to ACDF and CDA in terms of safety and feasibility. Cardoso et al 4 evaluated a cervical hybrid arthroplasty (ACDF + Prestige ST cervical disc [Medtronic Sofamor Danek]) in patients with multilevel cervical spondylosis, and found that this hybrid cervical arthroplasty is a safe and effective alternative to multilevel fusion.…”

Section: Discussionmentioning

confidence: 99%

Clinical and radiological results of two hybrid reconstructive techniques in noncontiguous 3-level cervical spondylosis

Kan¹,

Kang²,

Gao³

et al. 2014

SPI

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Object To date, formulation of the optimal surgical protocol for noncontiguous multilevel cervical spondylosis remains controversial, and the corresponding clinical data continue to be limited. The purpose of this study was to compare the clinical and radiological outcomes of two hybrid reconstructive techniques in noncontiguous 3-level cervical spondylosis (2 contiguous disc levels and 1 “skip” disc level [nonoperated level between 2 operated levels]). The incidence of adjacent-segment degeneration (ASD) was also evaluated. Methods Sixty-three consecutive patients with noncontiguous 3-level cervical spondylosis who underwent two different hybrid methods of treatment were retrospectively reviewed. The patients were divided into 2 groups, the fusion group and the arthroplasty group. A titanium mesh cage and an anterior cervical plate were used after the anterior cervical corpectomy, and then a stand-alone cage (the fusion group) or an artificial cervical disc (the arthroplasty group) was used after the discectomy. Clinical outcomes were assessed using the Japanese Orthopaedic Association (JOA) scale score and the JOA scale score improvement rate preoperatively and during follow-up. Radiological results were assessed using global angle and global range of motion (ROM) of the cervical spine. The ASD was also evaluated. Results The JOA scores of the patients significantly improved postoperatively and were well maintained within the follow-up period, as did the JOA scale score improvement rate. The mean global angle of the cervical spine of the patients significantly increased postoperatively. At the last follow-up evaluation, the mean global ROM was retained by patients in the arthroplasty group (p > 0.05) but not by patients in the fusion group (p = 0.00). There was no significant difference in the incidence of ASD between the 2 groups (p = 0.114). However, at the skip levels, patients in the fusion group had a higher incidence of ASD than patients in the arthroplasty group (p = 0.038). Conclusions Both of the hybrid procedures (anterior cervical corpectomy and fusion [ACCF] + anterior cervical discectomy and fusion, and ACCF + cervical disc arthroplasty [CDA]) yielded favorable clinical and radiological outcomes in the treatment of noncontiguous 3-level cervical spondylosis. Moreover, the ACCF + CDA procedure may have the ability to decrease the likelihood of ASD in appropriate patients.

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“…The present biomechanical study shows that HS could maintain segmental motion of the operative levels and have less adverse influence on adjacent levels. Therefore, HS may be a safe and effective alternative for multilevel cervical degenerative disc diseases [9].…”

Section: Z Liao Et Al / Coupled Motion Of Cervical Spine In Three Lmentioning

confidence: 99%

Coupled motion of cervical spine in three level hybrid constructs

Liao

Pu²,

et al. 2015

BME

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Abstract.To compare the biomechanical characters of three-level anterior cervical fusion and hybrid constructs by measuring coupled motion changes of the cervical spine, Eighteen adult human cadaveric cervical spines were biomechanically investigated under eccentric displacement control in lateral bending and axial rotation by measuring vertebral motion (X, Y, Z -axis).The 3DPD condition displayed similar coupled motion compared to the intact condition both in lateral bending and in axial rotation, while the 3PDP condition was similar only in lateral bending. However, the coupled motion of the cervical spine under 3P conditions markedly changed in both lateral bending and axial rotation. Considering the coupled motion characteristics, the 3DPD hybrid construct is biomechanically advantageous in three types of reconstructions (3DPD, 3PDP, 3P).

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Is hybrid surgery of the cervical spine a good balance between fusion and arthroplasty? Pilot results from a single surgeon series

Abstract: HS is comparable to ACDF and ADR in terms of safety and feasibility. Findings of shorter in-hospital stay and earlier return to work in HS group may be further explored in large, randomised controlled trials.

Cited by 60 publications

References 25 publications

Artificial Disk Replacement Combined With Fusion Versus 2-Level Fusion in Cervical 2-Level Disk Disease With a 5-Year Follow-up

Artificial Disk Replacement Combined With Fusion Versus 2-Level Fusion in Cervical 2-Level Disk Disease With a 5-Year Follow-up

Clinical and radiological results of two hybrid reconstructive techniques in noncontiguous 3-level cervical spondylosis

Coupled motion of cervical spine in three level hybrid constructs

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