{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T06:18:37Z","timestamp":1783491517556,"version":"3.55.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In recent years, hybrid surgery (HS) has emerged as one of the major surgical modalities for the treatment of multisegmental cervical degenerative disease (CDD). Two types of HS have been introduced (HS1, 1-level TDR with 2-level anterior cervical discectomy and fusion, ACDF or HS2, 2-level TDR with 1-level ACDF), and the clinical and radiological results could differ.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. The Web of Science Core Collection, PubMed and Embase were comprehensively searched from inception to December 19, 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five studies were included in this network meta-analysis. The Neck disability index (NDI) in the HS1 was significantly lower than that in the ACDF. The C2-7 range of motions (ROMs) in the HS1 and HS2 were both significantly greater than those in the ACDF. The C2-7 ROM in the HS1 was significantly lower than that in the HS2. The ROMs of the upper and lower segments in the HS1 and HS2 were both significantly lower than those in the ACDF. No significant difference was identified in the ROM of the upper or lower segment between the HS1 and the HS2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HS1, HS2 and ACDF are all safe and effective surgical options for three-level CDD. HS1 and HS2 could better preserve the C2-7 ROM. ACDF is associated with an increased ROM of adjacent segments. Compared with HS1, HS2 could better preserve the C2-7 ROM. HS1, HS2 and ACDF presented similar incidences of ASD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251271417<\/jats:ext-link>\n                      , PROSPERO (CRD420251271417).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1882426","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:56:36Z","timestamp":1783490196000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of hybrid surgeries for the treatment of three-level cervical degenerative disease: a systematic review and network meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Jiyuan","family":"Liao","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University","place":["Chengdu, China"]},{"name":"West China School of Nursing, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuchen","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunfei","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University","place":["Chengdu, China"]},{"name":"West China School of Nursing, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjie","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University","place":["Chengdu, China"]},{"name":"West China School of Nursing, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"B1","doi-asserted-by":"crossref","DOI":"10.23970\/AHRQEPCCER266","volume-title":"Cervical Degenerative Disease Treatment: A Systematic Review","author":"Selph","year":"2023"},{"key":"B2","doi-asserted-by":"publisher","first-page":"607","DOI":"10.2106\/00004623-195840030-00009","article-title":"The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion","volume":"40","author":"Smith","year":"1958","journal-title":"J Bone Joint Surg Am"},{"key":"B3","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1016\/j.wneu.2024.07.102","article-title":"Anterior cervical discectomy and fusion with zero-profile anchored spacer versus plate and cage for 3-level contiguous cervical degenerative disease: a systematic review and meta-analysis","volume":"190","author":"Chen","year":"2024","journal-title":"World Neurosurg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1007\/BF01358747","article-title":"Anterior cervical allograft arthrodesis and instrumentation: multilevel interbody grafting or strut graft reconstruction","volume":"6","author":"Swank","year":"1997","journal-title":"Eur Spine J"},{"key":"B5","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1097\/00007632-199801150-00006","article-title":"The significance of hardware failure in anterior cervical plate fixation. 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