İzmir Tınaztepe Üniversitesi Tıp Fakültesi, Nöroşirürji Anabilim Dalı, 35400 Buca, İzmir, Türkiye.
Jt Dis Relat Surg. 2024 Jul 8;35(3):596-602. doi: 10.52312/jdrs.2024.1663.
The study aims to explore the management of two-level cervical disc disease and to compare outcomes of anterior cervical discectomy and fusion (ACDF), cervical disc arthroplasty (CDA), and hybrid surgery (HS).
Between December 2011 and December 2021, a total of 120 patients (76 males, 44 females; mean age: 44.8±8.1 years; range, 18 to 68 years) who were diagnosed as two-level cervical disc disease and underwent anterior cervical surgery were retrospectively analyzed. The patients were randomly divided into three groups as ACDF, CDA, and HS each consisting of 40 patients. The Neck Disability Index (NDI), Visual Analog Scale (VAS), clinical and radiological findings, and range of motion (ROM) data were evaluated.
All of the groups showed a significant improvement according to clinical and radiological outcomes (p=0.01). The mean follow-up was 27.5±6.1 months for ACDF, 20.0±4.7 months for CDA, and 21.1±5.0 months for HS, showing consistency in monitoring post-surgery outcomes. The mean postoperative NDI scores were 13.4±5.6, 14.8±5.2 and 15.0±5.5 in the ACDF, CDA and HS groups, respectively (p=0.056). The mean postoperative ROM values were 20.82±5.66, 32.45±11.21 and 27.18±10.89, respectively (p=0.045).
All three surgical techniques, ACDF, CDA, and HS, are safe and successful in the treatment of two-level cervical disc disease. However, HS and CDA may be more preferable over ACDF attributed to their motion-preserving benefits and effectively combining fusion and motion preservation techniques, with comparable clinical and radiological outcomes.
本研究旨在探讨双节段颈椎间盘疾病的治疗方法，并比较前路颈椎间盘切除融合术（ACDF）、颈椎间盘置换术（CDA）和杂交手术（HS）的疗效。
回顾性分析 2011 年 12 月至 2021 年 12 月间 120 例（男 76 例，女 44 例；平均年龄 44.8±8.1 岁；年龄 18 至 68 岁）被诊断为双节段颈椎间盘疾病并接受前路颈椎手术的患者。患者随机分为 ACDF、CDA 和 HS 三组，每组各 40 例。评估颈椎功能障碍指数（NDI）、视觉模拟量表（VAS）评分、临床和影像学检查结果以及活动度（ROM）数据。
所有组的临床和影像学结果均有显著改善（p=0.01）。ACDF、CDA 和 HS 组的平均随访时间分别为 27.5±6.1、20.0±4.7 和 21.1±5.0 个月，监测术后结果的一致性较好。ACDF、CDA 和 HS 组术后 NDI 评分分别为 13.4±5.6、14.8±5.2 和 15.0±5.5（p=0.056）。术后 ROM 值分别为 20.82±5.66、32.45±11.21 和 27.18±10.89（p=0.045）。
ACDF、CDA 和 HS 三种手术技术治疗双节段颈椎间盘疾病均安全有效。然而，HS 和 CDA 可能比 ACDF 更具优势，因为它们具有保留运动的益处，并能有效地将融合和运动保留技术相结合，具有相似的临床和影像学结果。
