Anterior Approaches for Two-Level Cervical Degenerative Disease: A Comparative Study of at least 6-Year Follow-Up.

Abstract

ObjectiveTo compare the clinical and radiogrincaphic results of a hybrid surgery (HS) and cervical artificial disc replacement (ADR) for contiguous two-level cervical spondylosis.MethodsA total of 56 patients with contiguous two-level degenerative cervical spondylosis who underwent cervical HS and ADR via an anterior approach and completed at least 6 years of follow-up were included in this study. Patients were divided into two groups: group I, comprising 22 patients who underwent ADR, and group II, comprising 34 patients who underwent HS combined ADR and anterior cervical discectomy and fusion using a cage. Clinical outcomes were evaluated based on the visual analog scale (VAS) scores for arm pain, neck disability index (NDI), and modified MacNab criteria. Radiological parameters were assessed by measuring the bone fusion status, cervical range of motion (ROM C2-C7), heterotopic ossification (HO), adjacent segment disease (ASD) incidence, and fused segment height (FSH).ResultsThe VAS scores and NDI significantly improved in both groups, without significant differences between the groups. The incidences of HO, ROM C2–C7, and FSH were similar between groups, without significant differences. New osteophyte formation and osteophyte enlargement at adjacent segments were more frequently found in the HS group; however, the difference was not significant.ConclusionClinical results of this study showed that the clinical efficacy and radiological changes in HS were similar to those of ADR. HS can be an alternative procedure for the treatment of two-level cervical spondylosis.