Cervical Disc Arthroplasty and Hybrid Surgery Versus Anterior Cervical Discectomy and Fusion in the Treatment of Single and Multiple Cervical Disc Prolapse: A Comparative Reliability Study

Background: Cervical disc prolapse frequently causes radiculopathy and myelopathy. The Smith-Robinson anterior cervical discectomy and fusion (ACDF) technique, established in 1958, remains widely used with its modifications. Motion-preserving surgical alternatives aim to minimize adjacent segment degeneration (ASD). This study compares ACDF with arthroplasty and hybrid procedures. Methods: This retrospective cohort study analyzed 40 patients with cervical discs prolapse, assigned to ACDF (n=20) or arthroplasty/hybrid groups (n=20). Primary outcomes assessed at 12-month follow-up included Cobb's angle assessment, cervical range of motion (ROM), ASD incidence, Neck Disability Index (NDI), and complications. Results: The arthroplasty/hybrid group exhibited significantly superior ROM preservation (54.0° vs. ACDF 44.8°; p<0.001) and reduced ASD occurrence (10% vs. 25%; p=0.042). Functional outcomes demonstrated comparable NDI improvement (arthroplasty/hybrid: 31.2 vs. ACDF: 35.8; p=0.09). Arthroplasty/hybrid procedures required moderately longer operative durations (118±18 vs. 105±15 minutes; p=0.03). Complication profiles were similar (5% each). Conclusion: Motion-preserving surgical methods yield superior biomechanical results, including decreased ASD risk, relative to ACDF, while achieving equivalent short-term clinical efficacy. The established Smith-Robinson technique remains effective, but arthroplasty/hybrid approaches present advantages for maintaining segmental motion.