• Junbo He, Chen Ding, Hao Liu, Tingkui Wu, Kangkang Huang, Ying Hong, Yang Meng, and Beiyu Wang.
• Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, China.
• World Neurosurg. 2020 Nov 1; 143: e127-e135.

ObjectiveTo investigate whether anterior bone loss (ABL) in cervical discarthroplasty (CDA) in 2-level hybrid surgery (HS) is affected by adjacent fusion in vivo compared with 1-level CDA alone.MethodsA total of 180 patients undergoing either a 1-level CDA or contiguous 2-level HS were retrospectively reviewed. The clinical and radiographic outcomes were collected preoperatively and at routine postoperative intervals of 1 week, 3, 6, and 12 months, and at the last follow-up. The initial and postoperative radiographs were compared to determine the incidence and degree of ABL.ResultsABL was identified in 68.7% of CDA cases (37.9% mild, 34.8% moderate, and 27.3% severe) and 44.0% of HS cases (54.1% mild, 27.0% moderate, and 18.9% severe). Sex, age, bone mineral density, operation time, blood loss, postoperative alignment, and range of movement at the arthroplasty segment were not related to the incidence of ABL. According to the logistic regression analysis results, ABL showed a significant correlation with the surgery type and body mass index. However, there was no significant difference in the incidence and degree of ABL with or without an adjacent fusion level. Compared with preoperative values, clinical outcome scores significantly improved after surgery in both the HS and CDA groups. No definite clinical effect associated with ABL was found.ConclusionsABL was common in both CDA and HS. Although HS had a lower incidence rate and degree than did CDA, the fusion location in HS did not affect the ABL of adjacent CDA.Copyright © 2020 Elsevier Inc. All rights reserved.

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