• Lingyun Hu, Tingkui Wu, Hao Liu, Beiyu Wang, Jianying Zhang, Yang Meng, Chen Ding, Xinlin Gao, and Ying Hong.
• Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Orthopaedic Surgery, Nanchong Central Hospital, Second Clinical Medical College of North Sichuan Medical College, Nanchong, Sichuan, China.
• World Neurosurg. 2019 Dec 1; 132: e929-e940.

ObjectiveTo investigate whether the behavior of disc arthroplasty in 2-level hybrid surgery (HS) was affected by adjacent fusion in vivo compared with cervical disc arthroplasty (CDA) alone.MethodsSeventy-nine patients undergoing either a 1-level CDA or contiguous 2-level HS were retrospectively reviewed. Radiologic assessments included segmental lordosis (SL), intervertebral disc height (IDH), changes in SL and IDH, range of motion (ROM) of the disc replacement and its adjacent segments, migration and subsidence of the prosthesis, heterotopic ossification (HO), and adjacent segment degeneration (ASD) adjacent to the arthroplasty level. Clinical features and outcome scores were also recorded.ResultsCompared with 1-level CDA, the increased SL and IDH immediately after surgery in 2-level HS were more likely to be lost throughout the follow-up period. However, both groups generally maintained the SL and IDH of the arthroplasty segment postoperatively. Two-level HS did not exhibit hypermobility of the disc prosthesis and preserved preoperative ROM of the adjacent segment of the device. The HS group showed adverse effects on the prosthesis stability, but there was no significant difference in the number of cases of obvious migration or subsidence between the groups. The differences in HO, ASD, and clinical outcomes between the groups were not significant at the final follow-up.ConclusionsAlthough the fusion in 2-level HS partially affected the behavior of adjacent disc arthroplasty compared with CDA alone, it did not cause severe complications and adverse clinical outcomes. However, large-scale and long follow-up trials are warranted.Copyright © 2019 Elsevier Inc. All rights reserved.

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