Hybrid Cervical Disc Replacement and Discectomy with Fixation: An Innovative Approach to Cervical Spine Surgery

Hybrid cervical disc replacement (CDR) and discectomy with fixation is an innovative surgical technique that combines the benefits of CDR and anterior cervical discectomy and fusion (ACDF) in treating multilevel cervical spine disorders.

This article discusses the indications, techniques, benefits, and risks of this hybrid approach.

Indications

Hybrid CDR and discectomy with fixation is indicated for patients with multilevel cervical spine degeneration, including degenerative disc disease, cervical spondylosis, and radiculopathy.

This procedure is suitable for individuals who require surgery on two or more cervical levels but are not ideal candidates for multilevel CDR or ACDF alone.

Technique

The hybrid cervical disc replacement and discectomy with fixation procedure begins with an anterior cervical discectomy, where the damaged disc is removed to relieve pressure on the spinal cord and nerve roots.

In the hybrid approach, CDR is performed at one level, while ACDF is performed at another level. The surgeon selects the levels for CDR and ACDF based on the specific patient's pathology and needs.

Benefits

The hybrid CDR and discectomy with fixation offer several benefits over traditional multilevel ACDF, including:

• Motion preservation: CDR helps maintain the natural motion of the cervical spine, reducing the risk of adjacent segment degeneration.
• Improved biomechanics: The combination of CDR and ACDF provides better spinal stability and reduces stress on adjacent levels.
• Faster recovery: Patients undergoing hybrid surgery may experience shorter hospital stays and faster recovery times.

Risks

As with any surgical procedure, hybrid CDR and discectomy with fixation carry certain risks, including infection, bleeding, nerve injury, and implant failure. However, the overall complication rates for hybrid surgery are comparable to those of traditional multilevel ACDF.

Published Evidence on Hybrid Cervical Disc Replacement and Discectomy with Fixation

• Several studies have demonstrated the benefits of hybrid CDR and discectomy with fixation surgery over multilevel ACDF.
• A study by Hey et al. (2017) reported that patients undergoing hybrid surgery had better clinical outcomes, including improved neck disability index scores and lower reoperation rates.
• Similarly, a meta-analysis by Ren et al. (2018) found that hybrid surgery led to superior clinical outcomes and reduced adjacent segment degeneration compared to multilevel ACDF.

Hybrid cervical disc replacement and discectomy with fixation offer a promising alternative to traditional multilevel ACDF in treating cervical spine disorders.

The hybrid approach combines the benefits of CDR and ACDF, allowing for motion preservation, improved biomechanics, and faster recovery.

However, patients should carefully consider the potential risks and discuss them with their surgeon to make an informed decision about their treatment options.

References

• Hey, H. W., Hong, C. C., Long, A. S., Hee, H. T. (2017). Is hybrid surgery of the cervical spine a good balance between fusion and arthroplasty? Pilot results from a single surgeon series. European Spine Journal, 26(2), 477-486.
• Ren, X., Chu, T., Jiang, T., Wang, W., Wang, J., Li, C., & Chen, N. (2018). Hybrid surgery versus anterior cervical discectomy and fusion in multilevel cervical disc diseases: a meta-analysis. Medicine, 97(24), e11007.