Thelma, I have seen several hybrids performed in the US. However, I've never seen one with a Bryan disc because I don't know a surgeon who would consider using a Bryan. Many of the surgeons I know started with the Bryan because it was the first viable cervical ADR. However, as soon as an alternative was available, they jumped ship because the Bryan procedure is very difficult, complex and prone to complications. These issues have been solved or greatly improved by the later designs.
Mark
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