Comparison of anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in the treatment of localized ossification of the posterior longitudinal ligament
Background The retrospective study was conducted to compare the efficacy of anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) for localized ossification of the posterior longitudinal ligament (OPLL) by evaluating clinical and radiologic outcomes. Metho...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-03-01
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| Series: | Journal of Orthopaedic Surgery |
| Online Access: | https://doi.org/10.1177/10225536231167704 |
| _version_ | 1797859057274454016 |
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| author | Tangyiheng Chen MD Yujie Wang MD Hong Zhou MD Cheng Lin MD Xuefeng Li MD Huilin Yang MD Yijie Liu MD Weimin Jiang MD |
| author_facet | Tangyiheng Chen MD Yujie Wang MD Hong Zhou MD Cheng Lin MD Xuefeng Li MD Huilin Yang MD Yijie Liu MD Weimin Jiang MD |
| author_sort | Tangyiheng Chen MD |
| collection | DOAJ |
| description | Background The retrospective study was conducted to compare the efficacy of anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) for localized ossification of the posterior longitudinal ligament (OPLL) by evaluating clinical and radiologic outcomes. Methods We reviewed 151 patients to assess the effects of treatment for one or two levels localized OPLL. Perioperative parameters, such as blood loss, operation time and complications, were recorded. Radiologic outcomes, such as the occupying ratio (OR), fusion status, cervical lordosis angle, segmental angle, disc space height, T1 slope, and C2–C7 sagittal vertical axis (SVA), were assessed. Clinical indices, such as the JOA scores and VAS scores, were investigated to compare the two surgical options. Results There were no significant differences in the JOA scores or VAS scores between the two groups ( p > 0.05). The operation time, volume of blood loss and incidence of dysphagia were significantly less in the ACDF group than in the ACCF group ( p < 0.05). In addition, cervical lordosis, segmental angle and disc space height were significantly different from their preoperative evaluations. No adjacent segment degenerated in the ACDF group. The subsidence rates of implants were 5.2% in the ACDF group and 28.4% in the ACCF group. The degeneration of the ACCF group was 4.1%. The incidence of CSF leaks was 7.8% in the ACDF group and 13.5% in the ACCF group. All the patients ultimately achieved successful fusion. Conclusion Although both options achieved satisfactory primary clinical and radiographic efficacies, ACDF was associated with a shorter surgical procedure, less intraoperative blood loss, better radiologic outcomes, and lower incidence of dysphagia than ACCF. |
| first_indexed | 2024-04-09T21:23:19Z |
| format | Article |
| id | doaj.art-fd95f5d2d49f4d21882a8b6161cbb0ff |
| institution | Directory Open Access Journal |
| issn | 2309-4990 |
| language | English |
| last_indexed | 2024-04-09T21:23:19Z |
| publishDate | 2023-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Orthopaedic Surgery |
| spelling | doaj.art-fd95f5d2d49f4d21882a8b6161cbb0ff2023-03-28T03:33:37ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902023-03-013110.1177/10225536231167704Comparison of anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in the treatment of localized ossification of the posterior longitudinal ligamentTangyiheng Chen MDYujie Wang MDHong Zhou MDCheng Lin MDXuefeng Li MDHuilin Yang MDYijie Liu MDWeimin Jiang MDBackground The retrospective study was conducted to compare the efficacy of anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) for localized ossification of the posterior longitudinal ligament (OPLL) by evaluating clinical and radiologic outcomes. Methods We reviewed 151 patients to assess the effects of treatment for one or two levels localized OPLL. Perioperative parameters, such as blood loss, operation time and complications, were recorded. Radiologic outcomes, such as the occupying ratio (OR), fusion status, cervical lordosis angle, segmental angle, disc space height, T1 slope, and C2–C7 sagittal vertical axis (SVA), were assessed. Clinical indices, such as the JOA scores and VAS scores, were investigated to compare the two surgical options. Results There were no significant differences in the JOA scores or VAS scores between the two groups ( p > 0.05). The operation time, volume of blood loss and incidence of dysphagia were significantly less in the ACDF group than in the ACCF group ( p < 0.05). In addition, cervical lordosis, segmental angle and disc space height were significantly different from their preoperative evaluations. No adjacent segment degenerated in the ACDF group. The subsidence rates of implants were 5.2% in the ACDF group and 28.4% in the ACCF group. The degeneration of the ACCF group was 4.1%. The incidence of CSF leaks was 7.8% in the ACDF group and 13.5% in the ACCF group. All the patients ultimately achieved successful fusion. Conclusion Although both options achieved satisfactory primary clinical and radiographic efficacies, ACDF was associated with a shorter surgical procedure, less intraoperative blood loss, better radiologic outcomes, and lower incidence of dysphagia than ACCF.https://doi.org/10.1177/10225536231167704 |
| spellingShingle | Tangyiheng Chen MD Yujie Wang MD Hong Zhou MD Cheng Lin MD Xuefeng Li MD Huilin Yang MD Yijie Liu MD Weimin Jiang MD Comparison of anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in the treatment of localized ossification of the posterior longitudinal ligament Journal of Orthopaedic Surgery |
| title | Comparison of anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in the treatment of localized ossification of the posterior longitudinal ligament |
| title_full | Comparison of anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in the treatment of localized ossification of the posterior longitudinal ligament |
| title_fullStr | Comparison of anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in the treatment of localized ossification of the posterior longitudinal ligament |
| title_full_unstemmed | Comparison of anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in the treatment of localized ossification of the posterior longitudinal ligament |
| title_short | Comparison of anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in the treatment of localized ossification of the posterior longitudinal ligament |
| title_sort | comparison of anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in the treatment of localized ossification of the posterior longitudinal ligament |
| url | https://doi.org/10.1177/10225536231167704 |
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