scholarly journals Anterior Cervical Corpectomy with Fusion versus Anterior Hybrid Fusion Surgery for Patients with Severe Ossification of the Posterior Longitudinal Ligament Involving Three or More Levels: A Retrospective Comparative Study

2021 ◽  
Vol 10 (22) ◽  
pp. 5315
Author(s):  
Takashi Hirai ◽  
Toshitaka Yoshii ◽  
Kenichiro Sakai ◽  
Hiroyuki Inose ◽  
Masato Yuasa ◽  
...  
Keyword(s):  
Perioperative Complications ◽  
Posterior Longitudinal Ligament ◽  
Fusion Rate ◽  
Implant Failure ◽  
Anterior Fusion ◽  
Cervical Corpectomy ◽  
Neurologic Outcomes ◽  
Hybrid Fusion ◽  
Anterior Cervical Corpectomy ◽  
Hybrid Group

Various studies have found a high incidence of early graft dislodgement after multilevel corpectomy. Although a hybrid fusion technique was developed to resolve implant failure, the hybrid and conventional techniques have not been clearly compared in terms of perioperative complications in patients with severe ossification of the posterior longitudinal ligament (OPLL) involving three or more levels. The purpose of this study was to compare clinical and radiologic outcomes between anterior cervical corpectomy with fusion (ACCF) and anterior hybrid fusion for the treatment of multilevel cervical OPLL. We therefore retrospectively reviewed the clinical and radiologic data of 53 consecutive patients who underwent anterior fusion to treat cervical OPLL: 30 underwent ACCF and 23 underwent anterior hybrid fusion. All patients completed 2 years of follow-ups. Implant migration was defined as subsidence > 3 mm. There were no significant differences in demographics or clinical characteristics between the ACCF and hybrid groups. Early implant failure occurred significantly more frequently in the ACCF group (5 cases, 16.7%) compared with the hybrid group (0 cases, 0%). The fusion rate was 80% in the ACCF group and 100% in the hybrid group. Although both procedures can achieve satisfactory neurologic outcomes for multilevel OPLL patients, hybrid fusion likely provides better biomechanical stability than the conventional ACCF technique.

Multilevel anterior cervical corpectomy and fibular allograft fusion for cervical myelopathy

1997 ◽  
Vol 86 (6) ◽  
pp. 990-997 ◽  
Author(s):  
R. Loch Macdonald ◽  
Michael G. Fehlings ◽  
Charles H. Tator ◽  
Andres Lozano ◽  
J. Ross Fleming ◽  
...  
Keyword(s):  
Cervical Myelopathy ◽  
Cerebrospinal Fluid Leak ◽  
Posterior Longitudinal Ligament ◽  
Morbidity Rate ◽  
Preoperative Pain ◽  
Duration Of Symptoms ◽  
Content Type ◽  
Cervical Corpectomy ◽  
The Mean ◽  
Anterior Cervical Corpectomy

✓ This study was conducted to determine the safety and efficacy of multilevel anterior cervical corpectomy and stabilization using fibular allograft in patients with cervical myelopathy. Thirty-six patients underwent this procedure for cervical myelopathy caused by spondylosis (20 patients), ossified posterior longitudinal ligament (four patients), trauma (one patient), or a combination of lesions (11 patients). The mean age (± standard deviation) of the patients was 58 ± 10 years and 30 of the patients were men. The mean duration of symptoms before surgery was 30 ± 6 months and 11 patients had undergone previous surgery. Prior to surgery, the mean Nurick grade of the myelopathy was 3.1 ± 1.4. Seventeen patients also had cervicobrachial pain. Four vertebrae were removed in six patients, three in 19, and two in 11 patients. Instrumentation was used in 15 cases. The operative mortality rate was 3% (one patient) and two patients died 2 months postoperatively. Postoperative complications included early graft displacement requiring reoperation (three patients), transient dysphagia (two patients), cerebrospinal fluid leak treated by lumbar drainage (three patients), myocardial infarction (two patients), and late graft fracture (one patient). One patient developed transient worsening of myelopathy and three developed new, temporary radiculopathies. All patients achieved stable bone union and the mean Nurick grade at an average of 31 6 20 months (range 0–79 months) postoperatively was 2.4 ± 1.6 (p < 0.05, t-test). Cervicobrachial pain improved in 10 (59%) of the 17 patients who had preoperative pain and myelopathy improved at least one grade in 17 patients (47%; p < 0.05). Twenty-six surviving patients (72%) were followed for more than 24 months and stable, osseous union occurred in 97%. These results show that extensive, multilevel anterior decompression and stabilization using fibular allograft can be achieved with a perioperative mortality and major morbidity rate of 22% and with significant improvement in pain and myelopathy.

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