Skip corpectomy and fusion (SCF) versus anterior controllable antedisplacement and fusion (ACAF): which is better for patients with multilevel cervical OPLL?
- 29 Downloads
The aim of this study was to compare the clinical efficacy and radiological outcomes of skip corpectomy and fusion (SCF) with anterior controllable antedisplacement and fusion (ACAF) for treating multilevel ossification of the posterior longitudinal ligament (OPLL).
62 patients with multilevel OPLL who had undergone SCF or ACAF were analyzed retrospectively. Types of OPLL, occupying ratio (OR), Japanese Orthopaedic Association (JOA) score, Recovery Rate (RR), Neck Disability Index (NDI) score, Cobb’s angles of C2–C7, operation time, blood loss, hospital stay, ratings for fusion assessment and complications were recorded and assessed.
Postoperative C2–C7 Cobb’s angle (11.1 ± 3.2° vs. 13.7 ± 2.5°; P < 0.05), NDI scores at final follow-up (14.3 ± 1.6 vs. 13.3 ± 1.3; P < 0.05), and rate of cerebral fluid (CSF) leakage (5, 16.7% vs. 0,0%; P < 0.05) were significantly better in the ACAF group. At 6 months, bone graft fusion rate was significantly greater in the ACAF group (24.75% vs. 15.50%; P < 0.05).
Surgical treatment of multilevel OPLL by SCF or ACAF showed no significant differences in clinical outcomes, with the exception of better NDI scores at final follow-up in ACAF. In addition, ACAF is better than SCF in terms of early bone graft fusion rate, lordotic curvature improvement, risk of CSF leakage.
KeywordsSkip corpectomy and fusion (SCF) Anterior controllable antedisplacement fusion (ACAF) Ossification of the posterior longitudinal ligament (OPLL) Fusion rate Complication
This study was supported by grants from the National Natural Science. Foundation of China (No. 81650031), National Natural Science. Foundation of China (No. 81802218), and Shanghai Municipal Commission of Health and Family Planning (No. 201640262).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This article was approved by Medical Ethics Committee of Shanghai Changzheng Hospital. Approval file number: 2017SL040.
- 1.Hirabayashi K, Satomi K, Toyama Y (1998) Surgical management of OPLL: anterior versus posterior approach, Part II. In: The Cervical Spine Research Society Editorial Committee, ed. The Cervical Spine. 3rd edn. Lippincott-Raven, Philadelphia, pp 876–887Google Scholar
- 2.Qizhi S, Xuelei W, Lili Y, Lei L, Linwei C, Yang L et al (2012) Segmental anterior decompression and fusion for multilevel ossification of the posterior longitudinal ligament. Orthopedics 35(3):e403Google Scholar
- 5.Matz PG, Pritchard PR, Hadley MN (2007) Anterior cervical approach for the treatment of cervical myelopathy. Neurosurgery 60(1):64–70Google Scholar
- 11.Bone E (2010) “Skip” corpectomy in the treatment of multilevel cervical spondylotic myelopathy and ossified poster. Spinal Fusion 12:33–38Google Scholar
- 14.Sun J, Shi J, Xu X, Yang Y, Wang Y, Kong Q et al (2017) Anterior controllable antidisplacement and fusion surgery for the treatment of multilevel severe ossification of the posterior longitudinal ligament with myelopathy: preliminary clinical results of a novel technique. Eur Spine J 27(6):1–10Google Scholar
- 15.Sun JC, Zhang B, Shi J, Sun KQ, Le H, Xiao FS et al (2018) Can k-line predict the clinical outcome of anterior controllable antedisplacement and fusion surgery for cervical myelopathy caused by multi-segmental ossification of the posterior longitudinal ligament? World Neurosurgery e116:e118–e127CrossRefGoogle Scholar
- 18.Daniels AH, Riew KD, Yoo JU, Ching A, Birchard KR, Kranenburg AJ et al (2008) Adverse events associated with anterior cervical spine surgery. JAAOS 16(12):729–738Google Scholar
- 20.Yilmaz M, Yüksel KZ, Baek S et al (2012) Biomechanics of cervical ‘skip’ corpectomy versus standard multilevel corpectomy [J]. J Spinal Disord Tech 2:e783–e789Google Scholar