Hybrid Anterior Cervical Discectomy and Fusion and Cervical Disc Arthroplasty: An Analysis of Short-Term Complications, Reoperations, and Readmissions

1 I read with great interest the paper by Boddapati et al. 1 investigating the incidence of perioperative complications in patients who underwent hybrid surgery (HS) and 2-level anterior cervical discectomy and fusion (ACDF) for multilevel cervical disc disease (MLCDD). This study analyzed a retrospective cohort of prospectively collected data, between 2011 and 2018, by the American College of Surgeons Na-tional Surgical Quality Improvement Program of 390 and 27 340 patients treated with HS and 2-level ACDF, respec-tively. Patients were followed up 30 days after discharge. The authors found no signi fi cant difference in complication rate and operative duration between groups. Interestingly, the hospital length of stay was signi fi cantly shorter in the HS patients compared to 2-level ACDF ones. HS integrates ACDF and cervical disk arthroplasty (CDA) at different levels to combine the advantages of both techniques in terms of vertebral stability and spine motion preservation. 2 Therefore, the leading role of HS is to restore motion and promote fusion where indicated by the extent of the degenerative changes and hypermobility. 3 Accordingly, HS should provide a balance between ACDF and CDA in terms of both intraoperative and postoperative results.Theauthors ’ conclusions further support the role of HS as a reliable and safe procedure for the treatment of MLCDD. These results are in accordance with our team ’ s prospective 2-year follow-up study published in 2015. 4 Contrary to the results achieved by Boddapati et al., we showed that surgery duration was signi fi cantly