Hybrid anterior cervical discectomy and fusion and cervical disc replacement is a growing option for multilevel cervical disc degenerative disease, and early fusion rates are stronger, according to a study in the June 2025 issue of The Spine Journal.
Researchers compared early fusion rates at three to six months postoperatively in two-level ACDF and 2-level hybrid ACDF. The study measured outcomes for 376 patients who had surgery between January 2015 and January 2023.
Radiographic measures included fusion rate of the ACDF level, and researchers also took self-reported measures. Patients were grouped into three categories: 2-level ACDF (FF), dual-segment hybrid ACDF-ACDR (FR) and dual-segment ACDR-ACDF (RF).
Hybrid ACDF-ACDR patients saw the highest fusion rate after three months (70.7%), and after six months the same group saw fusion rates of 91.5%. After a year all groups saw fusions rates of at least 90% and the ACDF-ACDR group had a 100% fusion rate.
Researchers concluded, “The early fusion rate after two-level HS was higher than that after two-level ACDF. The early fusion rate of two-level HS was higher in the FR group than in the RF group. For two-level ACDF, the early fusion rate was higher in the proximal segment than in the distal segment. Additional biomechanical studies are needed to explore the biomechanical differences in fusion levels between HS and multilevel ACDF.”
