Is Motion Preservation With Three-Level Hybrid Cervical Surgery Achieved Without Compromising Clinical Outcomes? A Systematic Review and Meta-Analysis

= 0.93) comparable to ACDF. Fusion rates at intended arthrodesis levels were high and similar in both cohorts. There were no significant differences in total, early or late complication rates, although heterogeneity was moderate to high across several outcomes.ConclusionIn three-level cervical degenerative disease, hybrid surgery and ACDF provide equivalent improvements in pain, disability, neurological recovery, alignment, fusion success, and complication profiles. Hybrid constructs demonstrated a trend towards greater preservation cervical range of motion without compromising clinical efficacy or safety. These findings support hybrid surgery as a selective, motion-preserving alternative to three-level ACDF in appropriately chosen patients.Level of evidenceII.