title: [Two-level cervical artificial disc replacement combined with nearby segments fused for multi-level disc herniations].
abstract: OBJECTIVE
  To evaluate the therapeutic effect of the two-level cervical artificial disc replacements combined with the nearby segments fused for the multi-level disc herniations and to investigate their interaction during the treatment.
  
  
  METHODS
  The patient undergoing surgery was diagnosed as having intervertebral disc herniations in the C3 7 intervertebral discs. During the operation, the C(4-6) discs were replaced with two Bryan artificial discs while the C(3,1) and C(6,7) discs were removed, followed by the bone grafting and the Zephir instrumentation. The range of motion (ROM) was assessed before and immediately after operation by the flexion-extension radiography. The patient's functional exercise began as early as 2 days after operation and lasted for 3 weeks, followed by immobilization for 3 months.
  
  
  RESULTS
  According to the follow-up for 1 year and 2 months, the patient could move his neck in all directions without pain. The spinal and neural symptoms were significantly alleviated. ROM was close to the normal level postoperatively.
  
  
  CONCLUSIONS
  Artificial disc replacement combined with bone grafting and fusion is a new way to treat multi-level disc herniations surgically, with good clinical results. Early cervical functional exercise followed by restriction is an effective way to deal with the contradiction of motion and immobilization.
authors: Department of Orthopedic, West China Hospital, Sichuan University, PR China. liuhao6304@163.com
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