V.A. BYVALTSEV^1,2,3,4, I.A. STEPANOV¹, M.A. ALIEV¹, B.M. AGLAKOV¹, B.R. YUSUPOV¹, V.V. SHEPELEV¹

 ¹Irkutsk Irkutsk State Medical University, 1 Krasnogo Vosstaniya Str., Irkutsk, Russian Federation, 664003

²Railway Clinical Hospital on the station of Irkutsk-Passazhirskiy, 10 Botkina Str., Irkutsk, Russian Federation, 664005

³Irkutsk Scientific Center of Surgery and Traumatology, 1 Bortsov Revolutsii Str., Irkutsk, Russian Federation, 664003

⁴Irkutsk State Medical Academy of Postgraduate Education, 100 Microdistrict Yubileiniy, Irkutsk, Russian Federation, 664049

 Byvaltsev V.A. – D. Sc. (medicine), Chief Neurosurgeon of the Directorate of Healthcare of Russian Railways, Head of the Center for Neurosurgery of the Railway Clinical Hospital on the station of Irkutsk-Passazhirskiy of OJSC “RZD-Medicine”, Deputy Director for Innovation and International Activities, Head of the Department of Neurosurgery and Innovative Medicine, Head of the Scientific and Clinical Department of Neurosurgery, Professor of the Department of Traumatology, Orthopedics and Neurosurgery, Leading Researcher at Institute of Nuclear Physics named after G.I. Budker, tel. (3952) 63-85-28, e-mail: [email protected], ORCID ID:  0000-0003-4349-7101

Stepanov I.A. – Postgraduate Student of the Department of Neurosurgery and Innovative Medicine, tel. (3952) 63-88-30, e-mail: [email protected], ORCID ID: 0000-0001-9039-9147

Aliev M.A. – Doctoral Candidate of the Department of Neurosurgery and Innovative Medicine, tel. (7272) 28-07-77, e-mail: [email protected]

Aglakov B.M. – Postgraduate Student of the Department of Neurosurgery and Innovative Medicine, tel. (7272) 28-07-77, e-mail: [email protected]

Yusupov B.R. – Postgraduate Student of the Department of Neurosurgery and Innovative Medicine, tel. (7272) 28-07-77, e-mail: [email protected]

Shepelev V.V. – Doctoral Candidate of the Department of Neurosurgery and Innovative Medicine, tel. (3952) 63-88-30, e-mail: [email protected]

The objective is to evaluate the effectiveness of using a combination of total arthroplasty (TA) and anterior cervical spinal fusion (ACSF) in the surgical treatment of a two-level degenerative disease of cervical invertebral discs.

Material and methods. A single-site retrospective non-randomized cohort study was performed. The following clinical and instrumental parameters were evaluated: the patients’ level of life quality, associated with the index of restriction of movements in the cervical spine, the Neck Disability Index (NDI), severity of pain syndrome by the visual analogue scale (VAS) in the cervical spine and the upper extremities, motion amplitude of the spinal motion segment, frequency of the degenerative disease of the adjacent spinal motion segments, as well as indicators of the frequency of occurrence of secondary surgical interventions and adverse events. Results. The values of the quality of life of patients by NDI significantly increased (p<0.05), and the VAS severity of pain syndrome in cervical spine and upper limbs significantly decreased (p<0.05). The mean range of motion amplitude of the operated spinal motion segments did not significantly decrease (p>0.05). In 2 (5.8%) patients, clinical and instrumental signs of degeneration of adjacent segments were detected. In one case, secondary surgery was performed. Adverse events in the studied cohort of patients were not identified. Conclusions. The combination of TA and ACSF techniques is an effective method of surgical treatment of patients with a two-level degenerative disease of cervical intervertebral discs with an average postoperative follow-up of at least 12 months.

Key words: cervical spine, intervertebral disk, two-level degenerative disease, total arthroplasty, anterior cervical spinal fusion, combined surgery.

(For citation: Byvaltsev V.A., Stepanov I.A., Aliev M.A., Aglakov B.M., Yusupov B.R., Shepelev V.V. Combination of total arthroplasty and anterior cervical spinal fusion in the surgical treatment of a two-level degenerative disease of cervical intervertebral discs. Practical Medicine. 2018)

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