Clinical Results of Hybrid Surgery of Cervical Disc Replacement Combined with Fusion in Treating Three-level Cervical Spondylosis

Abstract：Objective To evaluate the effectiveness and safety of Prestige LP cervical disc replacement combined with Zero-Profile implant system interbody fusion intreating three-level cervical spondylosis.Methods Patients who underwent three-level hybrid surgery using Prestige LP and Zero-P between September 2012 and April 2015 were ret-rospectively analyzed,clinical and radiologic data were collected.The visual analogue score (VAS),Japan Orthopedic Association (JOA)score and neck disability index (NDI)were used to evaluate the clinical effect after surgery;cervical X-Rays and three-dimensional reconstruction CT scan were used to assess the postoperative prosthesis position and sta-bility,the replacement segment activity and heterotopic ossification,and fusion rate in fusion segments.Results 24 ca-ses were included in this study,9 patients underwent single level disc replacement+two-level interbody fusion,15 pati-etns underwent double-level disc replacement+single level interbodyfusion.39 Prestige LP artificial disc prosthesis and 33 Zero-P zero profile impalnts were impalnted at last.The VAS score,JOA score and NDI index at the final follow-up were significantly improved compared with that pre operation (P<0.05),no significant difference was found concern-ing the replacement segment range of motion between the final follow-up and preoperative (P>0.05),the overall cervi-cal range of motion decreased significantlycompared with preoperative (P<0.05).Conclusion Hybrid surgery of Pres-tige LP cervical disc replacement combined with Zero-Profile interbody fusion may be a safe and effective option for the treatment of three-level cervical spondylosis.It can effectively relief the clinical symptoms,maintain cervical segmental range of motion,reduce therisk of nonfusionand decrease the adjacent segmental intervertebral disc stress.