A hybrid technique for treating multilevel cervical myelopathy: Cervical artificial disc replacement combined with fusion

Clinical and radiographic outcomes of multilevel cervical myelopathy (MCM) patients treated with a hybrid technique combining cervical anterior corpectomy and fusion (ACF) with cervical artificial disc replacement (C-ADR) were evaluated. A total of 23 patients including 14 females and 9 males (mean age, 48.3 years) were treated with the hybrid technique and they were followed up for an average time of 35 months (range from 24 to 40 months). Arm- and neck-pain visual analogue scale (VAS) scores, neck disability index (NDI) scores and C2-7 range of motion (ROM) preoperation and 6 weeks, 3 and 24 months postoperation were assessed and compared. Fusion success and system failure based on anteroposterior (AP), lateral and flexion/extension X-rays were examined by an independent reviewer. Postoperative VAS, NDI and ROM were decreased significantly at all the time-points examined, as compared to preoperative scores (P<0.05). The results revealed that this hybrid technique is both technically feasible and effective for the treatment of MCM. However, future comparative studies will be required to determine the potential benefits and pitfalls of this hybrid technique.