Clinical Report: Evaluation of Hybrid Surgical Approaches for Managing Three-Level Cervical Degenerative Disease

Overview

This systematic review and network meta-analysis evaluates hybrid surgical approaches for three-level cervical degenerative disease (CDD).

Background

Cervical degenerative disease (CDD) is a common condition that can lead to significant morbidity due to spinal cord and nerve root compression. Traditional surgical approaches, such as anterior cervical discectomy and fusion (ACDF), have limitations, particularly concerning adjacent segment degeneration. Hybrid surgical techniques have emerged as potential alternatives that may offer improved outcomes in terms of motion preservation and complication rates.

Data Highlights

Key Findings

• HS1 (1-level TDR with 2-level ACDF) shows significantly lower Neck Disability Index (NDI) compared to ACDF.
• Both HS1 and HS2 (2-level TDR with 1-level ACDF) demonstrate significantly greater C2-7 range of motion (ROM) than ACDF.
• HS1 has a significantly lower C2-7 ROM compared to HS2.
• ROMs of upper and lower segments in HS1 and HS2 are significantly lower than in ACDF.
• No significant difference in ROM of upper or lower segments between HS1 and HS2.
• Incidences of adjacent segment degeneration (ASD) are similar across HS1, HS2, and ACDF.

Clinical Implications

Surgeons should consider the findings of this study when evaluating surgical options for patients with three-level CDD.

Conclusion

Hybrid surgical techniques for three-level cervical degenerative disease are safe and effective.

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