As a spine surgeon who is constantly looking for the best treatment options for my patients, the concept of “Hybrid Cervical Spine Surgery” has piqued my interest recently as it has been explored scientifically. Anterior cervical spine surgery is most commonly performed for patients with disc herniations in the neck. The disc herniation in the neck causes compression on the nerves that innervate the shoulders, arms and hands. The disc can pinch the nerves causing numbness, tingling and weakness in one or both arms. This can be very debilitating for patients as they can lose the use of one or both arms. The usual treatments include medications, injections and physical therapy, but when these methods don’t work, or the patient has weakness of the muscles of the arms, surgical options are considered.
Traditional Cervical Spine Surgery
Standard surgery is performed with an incision on the front of the neck which is used to gain access to the disc that resides just under the esophagus. The offending disc is removed and the nerve pressure is released. This leaves a space between the vertebral bones that needs to be filled to keep the neck stable. This reconstruction of the cervical spine has in the past 10 years slowly seen an increase in replacing the disc space with an implanted device that allows motion from the standard fusion that does not allow the segment to move. The thought process has been that the disc is what is causing the problem and not the bones, so we should remove the disc and continue to allow the bones (and therefore the spine) to function normally. This technique has been successful, especially in younger patients. As we get older and develop more arthritic degeneration in our discs, the discs are less mobile and the neck becomes stiffer. Disc replacements have not been as successful in restoring motion in those discs with advanced degeneration as they have been for younger patients with only a disc herniation.
Hybrid Cervical Spine Surgery
Recent investigations have focused on those patients with multiple levels of arthritis and nerve compression. In these patients, the degenerative changes in the discs may not be symmetrical, so should each disc be treated with the same reconstruction? Should both discs be fused with bone or both replaced with an implant that provides motion? New research in The Spine Journal (December 17, 2024) looks to this question with hybrid reconstruction of the cervical discs; one disc undergoing bone fusion and one disc reconstructed with an arthroplasty. The intent of the construct is to preserve as much of the natural motion in the cervical spine as possible. They created a study of 376 patients who were to undergo 2 level cervical spine surgery and split them into 3 surgical groups: fusion at both levels, disc replacement above a fused disc and disc replacement below a fused disc. They found that all of the patients got better, which is what is expected after cervical spine surgery. Interestingly, the 2 disc replacement groups had better surgical results than the fusion group. The early fusion rates were faster in the hybrid groups as compared to the 2-level fusion group.
Make an Appointment with Dr. Jeffrey Carlson, Spine Surgeon in Newport News, VA
Staying at the forefront of development in spine surgery allows Dr. Jeffrey Carlson and Orthopaedic & Spine Center to investigate surgery that will bring the best outcomes for all of our patients. Hybrid Cervical Surgery is another option for spine surgery to become more effective for more patients. To schedule a consult with Dr. Jeffrey Carlson or any of our spine surgeons in Newport News, call 757-596-1900 or request an appointment online.