The Official journal of the China Association of Rehabilitation of Disabled Persons and the 88th Hospital of PLA

Composite Impact Factor:

0. 948 (2015)

Total citation frequency: 3868 (2015)


ISSN 1005-8478

CN 37-1247/R

Hybrid surgery versus multi-level fusion for treatment of multi-level cervical spondylopathy

Author : SHI Ji-sheng, LIN Bin, GUO Feng,et al.     
Working unit : Departmentof Orthopaedics, Dezhou Peoples Hospital, Dezhou Shandong, 253000,China.
Page : 1927-1932
Key words : cervicalspine, total disc replacement, spinal fusion,hybridprocedure

Abstract:

Objective

To compare the clinical and radiological outcomes of artificial disk replacement plus cervical fusionthe hybrid procedureversus multi-segment anterior cervical diskectomy fusion ACDFfor treatment of multi-level cervical spondylopathy.

Methods

This retrospective study was conducted on clinical data of 62 patients with cervical spondylopathy continuously involving three levels received surgical treatment from April 2010 to October 2014. Of them, 26 patients underwent hybrid procedurethe hybrid group, which was combination of upper and lower artificial disk replacements with middle ACDF, whereas 36 patients received ACDFs at the continuous three levels involved the fusion group. Visual analogue scaleVAS, Neck Disability IndexNDIand Japanese Orthopaedic AssociationJOAscore were used for evaluation. In addition, angular range of motion ROMfor C2-7 measured radiologically was compared between two groups.

Results

There was no statistically significant differences between the two groups in terms of the gender, age, involved segment, and lesion type before the surgeryP>0.05. All the patients were followed up for at least 24 months. The VAS, NDI and JOA scores in both two groups significantly improved after operationP0.05. In addition, ROM of the C2-7 segments significantly decreased at 1, 6 months postoperatively compared to those preoperatively in both groups P0.05. However, the mean C2-7 ROM in the hybrid group recovered to the preoperative level at 12 months and the latest follow-up, whereas that in the fusion ACDF group did not return at the latest follow-up. The hybrid group was statistically superior to the fusion group in affected segment mobility at 1, 6, 12 months andthe latest follow upP<0.05.

Conclusion

For treatment of multi-level cervical spondylopathy, the hybrid procedure with advantage of preserving mobility of the affected spine does achieve satisfactory mid-term outcome. It is an effective alternative of multi-segment ACDF surgery.


summary:
Hybrid surgery versus multi-level fusion for treatment of multi-level cervical spondylopathy   
SHI Ji-sheng, LIN Bin, GUO Feng,et al.
Orthop J Chin,2017,25(21):   1927-1932