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Hybrid cervical disc arthroplasty.

Tsung-Hsi Tu^1,2,3, Jau-Ching Wu^1,2, Henrich Cheng^1,2

¹Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital.

Neurosurgical Focus

|January 3, 2017

Summary

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This study presents an alternative surgical approach for multilevel cervical stenosis, combining anterior cervical discectomy and fusion (ACDF) with cervical disc arthroplasty (CDA). This tailored treatment avoids extensive fusion, preserving motion in adjacent spinal segments.

Area of Science:

Neurosurgery
Spinal Surgery
Orthopedics

Background:

Traditional surgical management for nonadjacent multilevel cervical stenosis often involves fusion of all affected and intervening segments.
This approach can lead to adjacent segment disease and reduced spinal mobility.

Observation:

A 72-year-old female patient presented with myeloradiculopathy due to cervical stenosis at C3-4 and C5-6.
Nonoperative treatments were ineffective.

Findings:

The patient underwent a hybrid surgical technique: anterior cervical discectomy and fusion (ACDF) at C3-4 and cervical disc arthroplasty (CDA) at C5-6.
The intervening C4-5 segment was intentionally left untreated.
This approach successfully alleviated the patient's symptoms.

Keywords:

ACDF anterior cervical discectomy and fusion arthroplasty spondylosis video

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Implications:

This tailored combination of ACDF and CDA offers an alternative to extensive multilevel fusion for selected patients with cervical stenosis.
Preserving motion at the intervening C4-5 level may reduce the risk of adjacent segment degeneration.
This strategy maintains range of motion in two disc levels, potentially improving patient outcomes.