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Effect of novel unconstrained-type artificial disc in hybrid cervical surgery in terms of adjacent segment degeneration and motion preservation
Author(s): ,
J.-W. Hur
Affiliations:
Seoul St. Mary's hospital, Neurosurgery, spine center, Seoul, Korea, Republic of
,
K.-S. Ryu
Affiliations:
Seoul St. Mary's hospital, Neurosurgery, spine center, Seoul, Korea, Republic of
,
J.-S. Kim
Affiliations:
Seoul St. Mary's hospital, Neurosurgery, spine center, Seoul, Korea, Republic of
,
H.-J. Chung
Affiliations:
Seoul St. Mary's hospital, Neurosurgery, spine center, Seoul, Korea, Republic of
M.-S. Song
Affiliations:
Seoul St. Mary's hospital, Neurosurgery, spine center, Seoul, Korea, Republic of
EANS Academy. Song M. Oct 21, 2018; 225841; EP2092
Myung-Soo Song
Myung-Soo Song
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Abstract
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Background
Hybrid surgery, consisting of ADR combined with ACDF, has been reported with favorable results for 2-level cervical disease. The purpose of this study is to compare the clinical and radiologic outcome of cervical hybrid surgery using conventional semi-constrained-type artificial disc and novel unconstrained-type artificial disc in patients with 2-level disc disease in terms of adjacent segment degeneration and motion preservation.

Methods
82 patients with 2 consecutive level CDD underwent hybrid surgery were retrospectively reviewed. In study group, novel unconstrained-type artificial disc was inserted in ADR level and in control group, conventional semi-constrained type was used. Clinical outcomes were assessed by NDI, VAS scores for neck and arm pain, patients´ overall satisfaction and the usage of postoperative analgesics. Additionally, radiological measurements including angular ROM of C2-C7 and adjacent segments and any radiological evidence of adjacent segment degeneration were recorded.

Results
Both groups showed significant improvement in NDI and VAS scores postoperatively. Over 95% of patients in both group showed good to excellent results at the last visit and a significant reduction of analgesic usage was observed. The study group showed more rapid and greater C2-C7 ROM recovery compared to control group at the final follow-up. Although, superior adjacent segment ROM for both group remained hypo-mobile, the control group exhibited gradual increase. Significantly increased ROM at inferior adjacent segments was observed in both groups, but the compensatory ROM was less in study group. Adjacent disc space narrowing was observed equally in both groups.

Conclusion
The hybrid surgery may be a promising alternative to fusion surgery for CDD, but studies suggest still some degree of adjacent segment degeneration observed. In this study, hybrid surgery with novel unconstrained-type artificial disc demonstrated better neck pain improvement, C2-C7 ROM recovery and less impact at superior adjacent level compared to conventional semi-constrained-type
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