Clinical and Radiological Comparison of Hybrid Surgery and Fusion Application with Peek Cage in Patients Undergoing Three-Level Anterior Cervical Discectomy


Indian Journal of Orthopaedics, vol.56, no.7, pp.1227-1233, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 56 Issue: 7
  • Publication Date: 2022
  • Doi Number: 10.1007/s43465-022-00630-7
  • Journal Name: Indian Journal of Orthopaedics
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, CINAHL
  • Page Numbers: pp.1227-1233
  • Keywords: Cervical disk herniation, Cervical anterior fusion, Cervical arthrodesis, Cervical disk prosthesis, Cervical diskectomy, Cervical hybrid surgery, Hybrid surgery, Peek cage, Degenerative cervical disc herniation, Multiple level disk herniation
  • Istanbul Medipol University Affiliated: Yes


Objective: In this study, we aimed to compare patients with degenerative cervical disc herniation (CDH) who had undergone three-level anterior cervical discectomy (ACD) and fusion with a peek cage supported by synthetic bone graft in all levels to the cases with CDH with hybrid surgery (HS) regarding their radiological findings and surgical results. Materials and Methods: The patients who had undergone three-level ACD were evaluated retrospectively. The cases who were followed up for 2 years and longer were evaluated regarding gender, age, radiological findings, and patient satisfaction. A radiological assessment was made by calculating the Cobb angle on lateral cervical radiographs. Clinical assessment was performed by the Neck Disability Index (NDI). Results: In the first group, 13 patients had undergone ACD and fusion with peek cage and bone graft, and in the hybrid group, there were 11 patients in whom fusion with peek cage and bone graft were made in two levels, and cervical disc arthroplasty was performed throughout the distance in-between. In the hybrid group, the 1-month and 24-month changes in cervical range of motion in hyperflexion were statistically significant (p < 0.05). In both groups, significant improvements of NDI were determined postoperatively (p < 0.05). When the groups were compared, the 1-month and 24-month improvements were statistically significantly increased in the hybrid surgery group compared to the group that underwent fusion surgery with a cage (p < 0.05). Conclusions: HS is a reliable and effective treatment method in the three-level cervical disk disease for preserving and improving cervical ROM, particularly in the flexion position.