Study Design: Prospective study.

Objective: To study the validity of Hybrid construction (Anterior Lumbar Interbody Fusion) ALIF at one level and (Total Disc Arthroplasty) TDA at the adjacent level for two levels disc disease in the lumbar spine as an alternative surgical strategy compared to two levels disc arthroplasties.

Summary of Background Data: With growing evidence that fusion constructs in the treatment of DDD (Degenerative Disc Disease) may alter sagittal balance and contribute to undesirable complications in the long-term, total disc arthroplasty (TDA) slowly becomes an accepted treatment option for a selected group of patients. Despite encouraging early and intermediate term results of single-level total disc arthroplasty reported in the literature, there is growing evidence that two-level arthroplasty does not fare as well. Hybrid fusion is an attempt to address 2-level DDD by combining the advantages of a single-level ALIF with those of a single-level arthroplasty.

Conclusion: Clinical outcomes at 2 years show Hybrid fusion to be a viable surgical alternative for the treatment of 2-level DDD in comparison to two-level TDA.