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Artificial Disk Replacement Combined With Fusion Versus 2-Level Fusion in Cervical 2-Level Disk Disease With a 5-Year Follow-up

 Ji Gyu Yeul  ;  Oh Chang Hyun  ;  Shin Dong Ah  ;  Ha Yoon  ;  Yi, Seong  ;  Kim Keung Nyun  ;  Shin Hyun Cheol  ;  Yoon Do Heum 
 CLINICAL SPINE SURGERY, Vol.30(5) : 620-627, 2017 
Journal Title
Issue Date
Adult ; Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/physiopathology ; Cervical Vertebrae/surgery* ; Disability Evaluation ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration/diagnostic imaging ; Intervertebral Disc Degeneration/physiopathology ; Intervertebral Disc Degeneration/surgery* ; Intervertebral Disc Displacement/diagnostic imaging ; Intervertebral Disc Displacement/physiopathology ; Intervertebral Disc Displacement/surgery* ; Male ; Middle Aged ; Neck Pain/surgery ; Postoperative Complications/etiology ; Range of Motion, Articular ; Spinal Fusion*/adverse effects ; Total Disc Replacement*/adverse effects ; Treatment Outcome ; Visual Analog Scale
STUDY DESIGN: Prospective study. OBJECTIVE: The purpose of this study was to compare the long-term clinical and radiologic outcomes of hybrid surgery (HS) and 2-level anterior cervical discectomy and fusion (2-ACDF) in patients with 2-level cervical disk disease. SUMMARY OF BACKGROUND DATA: In a previous study with a 2-year follow-up, HS was shown to be superior to 2-ACDF, with a better Neck Disability Index (NDI) score, less postoperative neck pain, faster C2-C7 range of motion (ROM) recovery, and less adjacent ROM increase. MATERIALS AND METHODS: Between 2004 and 2006, 40 patients undergoing 2-level cervical disk surgery at our hospital were identified as 2-level degenerative disk disease. Forty patients were included in the previous study; 35 patients were followed up for 5 years. Patients completed the NDI and graded their pain intensity before surgery and at routine postoperative until 5 years. Dynamic cervical radiographs were obtained before surgery and at routine postoperative intervals and the angular ROM for C2-C7 and adjacent segments was measured. RESULTS: The HS group had better NDI recovery until 3 years after surgery (P<0.05). Postoperative neck pain was lower in the HS group at 1 and 3 years after surgery (P<0.05), but arm pain relief was not differently relieved. The HS group showed more angular ROM for C2-C7 at 2 and 3 years after surgery. The superior adjacent segment ROM showed hypermobility in the 2-ACDF group and hypomobility in the HS group at all follow-up periods without statistically significance, but the inferior adjacent segment ROM differed significantly (P<0.05). CONCLUSION: HS is superior to 2-ACDF; it leads to better NDI recovery, less postoperative neck pain, faster C2-C7 ROM recovery, and less adjacent ROM increase over a 2-year follow-up, but these benefits of HS become similar to those of 2-ACDF with 5 years of follow-up.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Keung Nyun(김긍년)
Shin, Dong Ah(신동아) ORCID logo https://orcid.org/0000-0002-5225-4083
Yoon, Do Heum(윤도흠) ORCID logo https://orcid.org/0000-0003-1452-5724
Yi, Seong(이성)
Ha, Yoon(하윤)
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