Objective      To evaluate the early clinical efficacy of artificial cervical disc replacement (ACDR) combined with anterior cervical discectomy and fusion (ACDF) in treatment of patients with multi-level cervical spondylosis

and to analyze the interaction effect between the replacement segment and fusion segment.       Methods 

     Fifteen patients with ACDR combined with ACDF (hybrid surgery

HS) and 15 patients with multi-level ACDF (M-ACDF) were enrolled in this retrospective study. Visual analogue scale (VAS) scores for neck and arm pain

neck disability index (NDI)

disc space height

total cervical range of motion (ROM)

and segmental ROM contribution to total cervical ROM were measured.       Results      The average duration of follow-up was 21.1 months in the HS group and 25.1 months in the M-ACDF group. VAS and NDI scores in both groups were significantly lower at all follow-up time points as compared with their preoperative scores (

P

0.01). Compared with preoperative scores

the replacement segmental ROM contribution to total cervical ROM in the HS group significantly increased at final follow-up (

P

0.05)

but no significant difference was observed in upper and lower adjacent segment (

P

0.05). However

the contribution of upper and lower adjacent segment in the ACDF group significantly increased as compared with the preoperative levels (

P

0.01). There was no complication related to the devices

such as loose

migration

and so on.       Conclusion      ACDR combined with ACDF in treatment of patients with multi-level cervical spondylosis can achieve satisfied early clinical efficacy. It not only maintains the cervical motion function

but also reduces the adjacent segment motion load after hybrid surgery. It is an alternative choice for multi-level cervical spondylosis treatment.