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Overloaded Vertebral Body Following Consecutive Three-Level Hybrid Surgery Comparing with Anterior Cervical
Shi-Hao Chen1, Ya-Ling Li2,3, Hao Liu1
1Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, China.
Orthopaedic Surgery
|October 15, 2024
Summary
Hybrid surgery (HS) involving cervical disc replacement (CDR) and anterior cervical discectomy and fusion (ACDF) reduced vertebral body collapse compared to ACDF alone. HS also led to better pain and disability scores, indicating improved clinical outcomes for cervical degenerative disc disease.
Area of Science:
- Spine surgery
- Orthopedics
- Degenerative disc disease
Background:
- Three-segment hybrid surgery (HS) combines cervical disc replacement (CDR) and anterior cervical discectomy and fusion (ACDF) with varying segment combinations.
- The impact of different HS configurations on overloaded vertebral body (OVB) occurrence is not well understood.
Purpose of the Study:
- To compare clinical and radiological outcomes of HS versus ACDF in treating cervical degenerative disc disease (CDDD).
- To investigate the occurrence of OVB in patients undergoing HS and ACDF.
Main Methods:
- Retrospective study of 123 patients with three-level CDDD undergoing ACDF or HS (Type I: 1 CDR/2 ACDF; Type II: 2 CDR/1 ACDF).
- Clinical outcomes assessed via VAS, JOA, and NDI scores.
- Radiological parameters included vertebral cross-sectional area, wedge angle (WA), anterior height (AH), posterior height (PH), and Hounsfield units (HU).
Main Results:
- Vertebral body collapse (VBC) was significantly lower in HS groups (Type I: 17.9%, Type II: 8.9%) compared to ACDF (41.5%).
- HS groups showed lower VAS neck and NDI scores at 3 and 6 months post-surgery.
- ACDF group had consistently lower WA and AH values in adjacent OVBs compared to HS groups.
Conclusions:
- Three-level HS effectively reduces stress concentrations and morphological changes in overloaded vertebral bodies.
- Higher VBC incidence was associated with Zero-P or Zero-P VA implants in the ACDF group.
