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Related Experiment Video

Updated: Apr 27, 2026

Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability
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Is Motion Preservation With Three-Level Hybrid Cervical Surgery Achieved Without Compromising Clinical Outcomes? A

Vibhu Krishnan Viswanathan1,2, Sathish Muthu2,3, Vaishnavi Sampathkumar4

  • 1Department of Orthopaedic Surgery, University of Alabama, Birmingham, AL, USA.

Global Spine Journal
|April 26, 2026
PubMed
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For three-level cervical degenerative disease, hybrid surgery and anterior cervical discectomy and fusion (ACDF) offer similar clinical outcomes and fusion rates. Hybrid constructs may better preserve cervical range of motion.

Area of Science:

  • Spine Surgery
  • Orthopedics
  • Neurosurgery

Background:

  • Degenerative cervical spine conditions often require surgical intervention.
  • Three-level anterior cervical discectomy and fusion (ACDF) is a common treatment.
  • Hybrid constructs combining ACDF and cervical disc arthroplasty (CDA) offer an alternative.

Purpose of the Study:

  • To compare clinical, radiographic, fusion, and complication outcomes between three-level ACDF and hybrid surgery.
  • To evaluate the efficacy and safety of motion-preserving hybrid constructs versus traditional fusion.

Main Methods:

  • Systematic review and meta-analysis of comparative studies.
  • Searched PubMed, Embase, Scopus, and Web of Science.
  • Included 12 studies with 1008 patients (553 hybrid, 455 ACDF).
Keywords:
cervical disc arthroplastyhybrid cervical surgerymeta-analysisrange of motionsystematic reviewthree-level ACDF

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Main Results:

  • Both strategies significantly improved Neck Disability Index (NDI), Visual Analogue Scale (VAS), and Japanese Orthopaedic Association (JOA) scores.
  • No significant differences in clinical outcomes, fusion rates, or complication rates were observed.
  • Hybrid constructs showed a trend towards preserving cervical range of motion (ROM).

Conclusions:

  • Hybrid surgery and ACDF yield comparable improvements in pain, disability, and neurological recovery for three-level cervical disease.
  • Hybrid constructs offer a motion-preserving alternative to ACDF without compromising safety or efficacy.
  • These findings support hybrid surgery for select patients with three-level cervical degenerative disease.