Anterior hybrid construction of multilevel cervical disc disease and spondylotic spinal stenosis: surgical results and factors affecting adjacent segment problems

• Published in: Journal of orthopaedic surgery and research Vol. 16; no. 1; p. 298
• Main Authors: Yilmaz, Murat, Yucesoy, Kemal, Erbayraktar, Resat S, Altinag, Rıfat S
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 05.05.2021; BioMed Central; BMC
• Subjects: Anterior cervical discectomy; Anterior hybrid construction; Central nervous system diseases; Clinical outcomes; Diagnostic imaging; Dysphagia; Fusion, Multilevel cervical spondylosis; Intervertebral discs; Magnetic resonance imaging; Medical imaging; Orthopedics; Pain; Patients; Physiology; Prostheses; Spinal canal; Spinal cord; Spinal stenosis; Spondylosis; Spondylotic spinal stenosis; Stenosis; Surgery; Total disc replacement; Anterior cervical discectomy; Anterior hybrid construction; Total disc replacement; Spondylotic spinal stenosis; Fusion, Multilevel cervical spondylosis
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-021-02393-7

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). 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. 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. Anterior cervical hybrid construction appears to be an acceptable option in the management of multilevel cervical degenerative disc diseases and spondylotic spinal stenosis.