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Joint Diseases and
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Original Article · Open access

Comparison of fusion, arthroplasty and hybrid surgery outcomes in patients with two-level cervical disc disease

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Alper Tabanli

Department of Neurosurgery, İzmir Tınaztepe University Faculty of Medicine, İzmir, Türkiye

ORCID: 0000-0002-2378-507X

Toygun Kağan Eren

Department of Orthopedics and Traumatology, Gazi University Faculty of Medicine, Ankara, Türkiye

ORCID: 0000-0002-4526-4216

Abstract

Objectives: The study aims to explore the management of two-level cervical disc disease and to compare outcomes of anterior cervical discectomy and fusion (ACDF), cervical disc arthroplasty (CDA), and hybrid surgery (HS).

Patients and methods: Between December 2011 and December 2021, a total of 120 patients (76 males, 44 females; mean age: 44.8±8.1 years; range, 18 to 68 years) who were diagnosed as two-level cervical disc disease and underwent anterior cervical surgery were retrospectively analyzed. The patients were randomly divided into three groups as ACDF, CDA, and HS each consisting of 40 patients. The Neck Disability Index (NDI), Visual Analog Scale (VAS), clinical and radiological findings, and range of motion (ROM) data were evaluated.

Results: All of the groups showed a significant improvement according to clinical and radiological outcomes (p=0.01). The mean follow-up was 27.5±6.1 months for ACDF, 20.0±4.7 months for CDA, and 21.1±5.0 months for HS, showing consistency in monitoring post-surgery outcomes. The mean postoperative NDI scores were 13.4±5.6, 14.8±5.2 and 15.0±5.5 in the ACDF, CDA and HS groups, respectively (p=0.056). The mean postoperative ROM values were 20.82±5.66, 32.45±11.21 and 27.18±10.89, respectively (p=0.045).

Conclusion: All three surgical techniques, ACDF, CDA, and HS, are safe and successful in the treatment of two-level cervical disc disease. However, HS and CDA may be more preferable over ACDF attributed to their motion-preserving benefits and effectively combining fusion and motion preservation techniques, with comparable clinical and radiological outcomes.

Declarations

Ethics Committee Approval

The study protocol was approved by the Izmir Bozyaka Training and Research Hospital Clinical Research Ethics Committee (date: 20.04.2022, no: 2022/66). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Informed Consent

A written informed consent was obtained from each patient.

Author Contributions

Idea/concept, design, data collection and/or processing, analysis and/or interpretation: A.T.; Control/supervision, references and fundings, critical review, material: A.T., T.K.E.; Literature review, writing the article: T.K.E.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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