Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2020; 8(17): 3890-3902
Published online Sep 6, 2020. doi: 10.12998/wjcc.v8.i17.3890
Surgical strategy used in multilevel cervical disc replacement and cervical hybrid surgery: Four case reports
Xiao-Fei Wang, Yang Meng, Hao Liu, Ying Hong, Bei-Yu Wang
Xiao-Fei Wang, Yang Meng, Hao Liu, Bei-Yu Wang, Department of Orthopaedic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Ying Hong, Department of Operation Room, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Wang XF contributed to manuscript drafting; Meng Y and Wang BY interpreted the imaging findings; Liu H was the patients’ surgeon; Liu H and Hong Y were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hao Liu, MD, PhD, Director, Professor, Department of Orthopaedic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, Sichuan Province, China. dr.liuhao6304@yahoo.com
Received: March 25, 2020
Peer-review started: March 25, 2020
First decision: July 4, 2020
Revised: July 18, 2020
Accepted: July 30, 2020
Article in press: July 30, 2020
Published online: September 6, 2020
Abstract
BACKGROUND

Multilevel artificial cervical disc replacement and anterior hybrid surgery have been introduced as reliable treatments for multilevel cervical degenerative disc disease. Surgical techniques are important for resolving patients’ symptoms and maintaining the normal functioning of cervical implants. However, the use of inappropriate surgical strategies could lead to complications such as implant migration and neurological deficit. In this paper, we summarize our surgical strategies used in multilevel cervical disc replacement and hybrid surgery into five major notes.

CASE SUMMARY

We share the key notes and our surgical procedures in the form of four typical case presentations. All patients were diagnosed with cervical degenerative disc disease with myelopathy or radiculopathy and needed multilevel cervical spine surgery. The first case demonstrated that index levels indicating the presence of highly serious spinal cord compression required a prioritized decompression. The second case demonstrated that the disc replacement should be performed before fusion in cervical hybrid surgery. The third and forth cases demonstrated that a top-down implantation sequence was needed in continuous two-level cervical disc replacement. The symptoms of all patients were significantly relieved after surgery.

CONCLUSION

We hope that our surgical strategies can help improve the performance and outcomes of multilevel cervical spine surgery.

Keywords: Cervical disc replacement, Cervical hybrid surgery, Multilevel cervical spine surgery, Surgical strategy, Implant migration, Case report

Core tip: We share our surgical strategies and surgical procedures in treating multilevel cervical degenerative disc disease in the form of four typical case presentations. We hope that our surgical strategies can help avoid the postoperative complications and improve the performance and outcomes of multilevel cervical spine surgery.