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A Real-World Analysis Of Hybrid CDA And ACDF Compared To Multilevel ACDF – Cervical Disc Replacement

The article discusses the safety and effectiveness of hybrid surgery compared to multilevel anterior cervical discectomy and fusion (mACDF) for the treatment of multilevel spinal disease. Hybrid surgery, which combines ACDF and cervical disc arthroplasty, aims to retain spinal mobility and reduce the risk of adjacent segment disease (ASD). The study analyzed administrative claims data and found that hybrid surgery was as safe and effective as mACDF. The rates of subsequent surgery and post-procedural hospitalization were similar between the two procedures, with slightly lower hospitalization rates observed for hybrid surgery patients at 90 days post-procedure. The analysis highlights the use of a larger and more generalizable population compared to previous small cohort studies. Overall, the findings confirm the safety and non-inferiority of hybrid surgery in treating multilevel spinal disease

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most established spinal centre in London

Published article

CONCLUSIONS: Findings of this real-world, retrospective cohort study confirm prior reports indicating that hybrid surgery is a safe and effective intervention for multilevel spinal disease which demonstrates non-inferiority in relation to the current gold standard mACDF. The use of administrative claims data in this analysis provides a unique perspective allowing the inclusion of a larger, more generalizable population has historically been reported on in small cohort studies.

Cervical Disc Arthroplasty Surgery Expert. Best Spinal Surgeon UK
Abstract Background: Multilevel anterior cervical discectomy and fusion (mACDF) is the gold standard for multilevel spinal disease; although safe and effective, mACDF can limit regular spinal motion and contribute to adjacent segment disease (ASD). Hybrid surgery, composed of ACDF and cervical disc arthroplasty, has the potential to reduce ASD by retaining spinal mobility. This study,

Abstract

Background: Multilevel anterior cervical discectomy and fusion (mACDF) is the gold standard for multilevel spinal disease; although safe and effective, mACDF can limit regular spinal motion and contribute to adjacent segment disease (ASD). Hybrid surgery, composed of ACDF and cervical disc arthroplasty, has the potential to reduce ASD by retaining spinal mobility. This study examined the safety of hybrid surgery by utilizing administrative claims data to compare real-world rates of subsequent surgery and post-procedural hospitalization within populations of patients undergoing hybrid surgery versus mACDF for multilevel spinal disease.

Methods: This observational, retrospective analysis used the MarketScan Commercial and Medicare Database from July 2013 through June 2020. Propensity score matched cohorts of patients who received hybrid surgery or mACDF were established based on the presence of spinal surgery procedure codes in the claims data and followed over a variable post-period. Rates of subsequent surgery and post-procedural hospitalization (30- and 90-day) were compared between hybrid surgery and mACDF cohorts.

Results: A total of 430 hybrid surgery patients and 2,136 mACDF patients qualified for the study; average follow-up was approximately 2 years. Similar rates of subsequent surgery (Hybrid: 1.9 surgeries/100 patient-years; mACDF: 1.8 surgeries/100 patient-years) were observed for the two cohorts. Hospitalization rates were also similar across cohorts at 30 days post-procedure (Hybrid: 0.67% hospitalized/patient-year; mACDF: 0.87% hospitalized/patient-year). At 90 days post-procedure, hybrid surgery patients had slightly lower rates of hospitalization compared to mACDF patients (0.23% versus 0.42% hospitalized/patient-year; p < 0.05).

Conclusions: Findings of this real-world, retrospective cohort study confirm prior reports indicating that hybrid surgery is a safe and effective intervention for multilevel spinal disease which demonstrates non-inferiority in relation to the current gold standard mACDF. The use of administrative claims data in this analysis provides a unique perspective allowing the inclusion of a larger, more generalizable population has historically been reported on in small cohort studies.

Keywords: Adjacent segment disease; Anterior cervical fusion; Cervical arthroplasty; Cervical spondylosis; Hybrid surgery; Intervertebral disc surgery; Spinal cord diseases.

The London Spine Unit : most established spinal centre in London

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A real-world analysis of hybrid CDA and ACDF compared to multilevel ACDF

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Abstract Background: Multilevel anterior cervical discectomy and fusion (mACDF) is the gold standard for multilevel spinal disease; although safe and effective, mACDF can limit regular spinal motion and contribute to adjacent segment disease (ASD). Hybrid surgery, composed of ACDF and cervical disc arthroplasty, has the potential to reduce ASD by retaining spinal mobility. This study

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